Medicine and Health Sciences Commons^™

Reporting Adherence To Resistance Training In Cancer Survivors And Their Partners: A Comparison Between Prescribed And Received Training Dose, Oliver Lumbad, Kerri Winters-Stone

McNair Symposium

Resistance training is increasingly recognized as a behavioral strategy that can negate the adverse effects of cancer treatment. The exercise prescriptions were derived from trial method reports which may not reflect the actual dose of exercise in relation to study outcomes. It is possible, therefore, that the dose of exercise necessary to evoke a particular benefit may differ from published recommendations. Purpose: To report exercise adherence and dose in a resistance training program for cancer survivors and their partners. Furthermore, we aim to assess tolerability, compliance, and strength outcomes by comparing received training volume. Methods: Preliminary data from 25 participants …

The Social Determinants Of Human Milk Banking: Impacts Of Demographic And Geographical Factors On Human Milk Donor Behavior, Zayba Z. Afshar, Claire Wheeler

McNair Symposium

Human milk banking is a vital source of milk for infants for a multitude of reasons. Many of which go to medically fragile infants in Newborn Intensive Care Units (NICUs). The purpose of this study is to learn about how the social determinants of health and graphical factors affect human milk donor behavior through GIS (Geographic Information System) mapping to provide recommendations on how to improve overall donor participation. This research was conducted through a partnership with a local human milk bank accredited by HMBANA called Northwest Mothers Milk Bank (NWMMB) located in Tigard, OR. Demographic and geographic data was …

Exploring How Gentrification-Related Effects Impact The Health Of Older Black Adults, Ann Wachana, Holly Hinson

McNair Symposium

Black adults living in gentrifying neighborhoods experience cultural incongruence with new, often younger, high SES and White residents. In addition, older Black adults are losing deep ties to their neighborhood. This is a major loss to their social network and their sense of belonging within their own neighborhoods. Disruption of long-standing social ties can cause changes in mental health and raises concerns about gentrification’s potentially disruptive impact on cognitive health and the brain aging process. In order to learn more about the experience of older Black adults within a rapidly changing city, focus group discussions from the Sharing History through …

The Role Of Neighborhood And Social Determinants Of Health: Investigating Health-Related Social Needs Among The Portland Metropolitan Area In Oregon, Roselie Agulto, Bruce Goldberg

McNair Symposium

Intersecting factors of social determinants of health have a significant impact on both individual and community well-being, however, a growing body of research highlights disproportionate disparities among neighborhood locations. Accessible resources, clinics, programs, and other community infrastructure are some characteristics that promote a healthy local economy. Locations lacking these aspects are where concentrated areas of poverty are inclined to exist, which often, correlate to higher rates of basic needs and adverse health outcomes. As part of the Accountable Health Communities (AHC) project—a 5-year research study to bridge the gap between clinical and social providers to lower hospitalization and total cost …

Using Blood Biomarkers To Predict Traumatic Brain Injury, Rosol Hatim Mikail, Martin Schreiber

McNair Symposium

Traumatic brain injury (TBI) is a serious medical condition that needs a diagnosis to be treated. The neurological exam used for diagnosis is not able to detect all TBIs. Without a TBI diagnosis, a patient is not able to get the necessary medical care in time which could potentially lead to long-term brain damage and mortality. Some blood biomarkers have been investigated and found to have a correlation with TBI. Testing the blood is more accessible to diagnose TBI; this could connect the patient with further medical treatment when a TBI is suspected through the test. In this experiment, the …

Exploring The Impact Of Interpersonal Trust On Health Outcomes In Rapidly Gentrifying Neighborhoods In Portland, Oregon, Julie Ha, Yves Labissiere

McNair Symposium

Social determinants have been recognized to be significant factors contributing to the overall health outcomes of individuals. However, there is limited research on how these factors have directly impacted the mental and physical wellness of people in neighborhoods who are experiencing rapid gentrification. The objective of this study is to determine whether the level of interpersonal trust present between individuals in neighborhoods is associated with the mental and physical health outcomes among its residents. This quantitative study uses the Albina-Rockwood Neighborhood Promise Survey, which uses data from a random sample of families living in two rapidly gentrified neighborhoods in Portland, …

Efficacy Of Curcumin In Asthma: A Systematic Review And Meta Analysis, Tabitha Grow, Adam Sadowski

McNair Symposium

Over 23 million people are affected by asthma in the United States and 262 million individuals globally. Asthma, if poorly controlled, is associated with significant morbidity as well as increased risk for mortality. Asthma involves several complex inflammatory pathways and processes including an increase in immune cell activation. Curcumin, the active constituent found in turmeric, has been studied in numerous in-vivo and in-vitro studies to generate anti-inflammatory effects in pulmonary diseases and, more recently, an increase in clinical data has become available. Since the most recent review assessing the role of curcumin in pulmonary disorders, additional clinical trials have been …

Ronald E. Mcnair Scholars Program Profiles And Abstracts 2021, Mcnair Scholars Program

McNair Symposium

This is the complete event program and provides presentation abstracts and biographies of McNair scholars and their mentors.

Remote Team Based Learning (Tbl) In The Covid Educational Landscape - Doing It From Scratch, Kathryn Eisenmann

Scholarship of Teaching and Learning (SoTL) Academy Conference (2021)

Presentation describes the development of a remote TBL platform using existing software for the University of Toledo College of Medicine.

Covid-19-Anxiety And Using Substances To Cope: Differences Across Race And Gender In A New York State College Student Sample, Laura Longo, Cara Fresquez, Jessica Martin, Natalie Sumski, M. Dolores Cimini

Addressing Differential Impacts of COVID-19 in New York State: A Symposium

College students, a high risk group for substance use and problems (White & Kingston, 2013), have reported heightened mental health concerns over the past few years (Oswalt et al, 2020). Prior research examining substance misuse and mental health concerns indicate the two tend to co-occur (Cranford et al., 2009). One of the greatest risk factors for future substance use disorder is using substances to cope with negative affect (Patrick et al., 2011). Research on the effect of the pandemic on college student’s mental health has documented increased levels of stress and anxiety, with women reporting worse well-being compared to men …

Lean Six Sigma As An Enabler For Healthcare Operational Excellence In Covid-19, Olivia Mcdermott Dr, Antony Jiju

International Conference on Lean Six Sigma

1. Purpose -This paper aims to present the results of a qualitative research interview study on the utilization and importance of Lean Six Sigma methods in the Healthcare sector in COVID-19 and in pandemics in general.
2. Design/methodology/approach -a qualitative interview approach was utilised by interviewing leading Lean Six Sigma academics and practitioners who are expert in and have experience in Lean Six Sigma.
3. Findings – Lean Six Sigma methods are proven and can be utilised in pandemic situations to improve efficiency and resilience in the healthcare system and readiness for pandemics.
4. Research limitations/implications - One limitation of this research was that …

Application Of Lean Six Sigma To Reduce The Cost Of Regulatory Noncompliance., Reham Nour, Chad Laux

International Conference on Lean Six Sigma

1. Purpose

This research focused on the adoption of Six Sigma within FDA-regulated pharmaceutical companies to create an effective CAPA system for reducing the cost of noncompliance and supporting organizational performance.

2. Design/Methodology/Approach

This study utilized the DMAIC methodology, in a case study, to improve the CAPA process within a medical device company regulated by the FDA. All the critical requirements for compliance CAPA system was being defined from the FDA sources and the DMAIC model was be applied to improve and maintain CAPA performance.

3. Findings

Using the DMAIC approach supported identifying the bottlenecks and process variation. within CAPA. …

2021 Prep Symposium Agenda, School Of Medicine

Postbaccalaureate Research Education Program in Biomedical Sciences (PREP)

No abstract provided.

Session 2: Access To Health And Health Services Panel - The Covid-19 Experience, Annette Clark, Wendy Chalres, Dan Laster, Anna Santos Rutschman, Madhavi Sunder, Margret Chon

SITIE Symposiums

COVID-19 has had a massive impact on the U.S. and the world regarding health care and health care access. Improving access has been the topic of scholarship for many years. It took the COVID- 19 pandemic to bring these issues to the forefront of public discussion. Inequities in public health access, not only domestically but globally, have become apparent in the light of COVID-19. This expert panel addresses the inequities of vaccines worldwide and the concept of vaccine sharing programs. It also explores the role that intellectual property plays in these equity issues and some of the risks inherent in …

Improving Utilization Of Sglt2 Inhibitors In The Inpatient Setting, Andrea Verghese, Md, Bharaniabirami Rajaram, Md, Fred Karaisz, Md, Jason Ho, Md, Kaya Patel, Md, Michael Grodsky, Md, Shifa Gandhi, Md, Xuejun Wang, Md, Yair Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

• SGLT2 inhibitors have been shown to have a significant benefit for patients with DM2 or CAD (DAPA-HF, Emperor-reduced)
• The usage of these medications are low compared to other Goal Directed Medical Therapy.
• There are multiple contributing factors as to why these medications are underutilized

Our aim is to assess barriers against prescription of SGLT2-i at the time of discharge from TJUH and to increase utilization after placement on formulary.

Improving Safety Of Direct Oral Anticoagulant (Doac) Dosing In Patients With Severe Chronic And End-Stage Renal Disease, Naman Upadhyay, Md, R. Mohammed, Md, Kirpal Kochar, Md, Max Ruge, Md, Sean Dikdan, Md, Yair Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

The significance of this study is to determine the degree of inconsistency in dosing practice of DOACs at a quaternary care institution such as Thomas Jefferson University Hospital.

1. What is the primary indication for anticoagulation in out population?
2. What percentage is dosed correctly?
3. Are patients primarily over or underdosed?

Evaluating The Efficacy Of A Nursing-Driven Versus Provider-Driven Heparin Protocol, Naman Upadhyay, Md, Joseph Soucy, Md, Steven Manobianco, Md, Samantha Sokoloff, Md, Sairamya Bodempudi, Md, Veda Pejaver, Md, Max Ruge, Md, Lynda Thomson, Pharmd, Lily Ackermann, Md

Health Equity and Quality Improvement (HEQI) Summit

At Thomas Jefferson University Hospital patients who require heparin infusions are monitored either by nursing alone or the resident and the nurse together.

This project aims to determine:

1. Which protocol more efficiently shortens the time to therapeutic?
2. Are patients therapeutic longer under a certain protocol?
3. Do more patients under either protocol suffer from bleeding complications?

Tolerability Of Switching Cholinesterase Inhibitors To Memantine Monotherapy Versus Adding Memantine As Combination Therapy For All-Cause Neurodegenerative Disorders, Estevana Isaac, Md, Mijail Serruya, Md, Phd, Keith Scott, Phd, Michael R. Sperling, Md, Carol Lippa, Md

Health Equity and Quality Improvement (HEQI) Summit

Background: Prior studies have focused on the clinical efficacy of combination therapy, Donepezil and Memantine, for patient’s diagnosed with Alzheimer’s disease. However, the potential adverse drug reactions while described as mild can have serious sequelae in older adults who are already managing the side effects of polypharmacy.

Objective: This study looks to explore the tolerability of switching cholinesterase inhibitors to memantine monotherapy versus adding memantine as combination therapy for all-cause neurodegenerative disorders.

Methods: The study is a retrospective chart review that includes 175 patients aged 50 and older diagnosed with neurocognitive disorders (ICD 10 F00-F03.91 and ICD10 G30-G31.84) managed on …

Decreasing Post Insulin Hypoglycemia Incidence In End Stage Renal Disease (Esrd) Patients, Anna Lo, Md, Rachana Mundada, Md, Eric Shiffrin, Md, Jenny Wang, Md

Health Equity and Quality Improvement (HEQI) Summit

ESRD patients are vulnerable to hypoglycemia due to impaired insulin clearance, glucose metabolism changes, and effects of dialysis. Hypoglycemic events lead to serious and life-threatening complications.

Aims for Improvement:

To decrease the rate of hypoglycemic events amongst ESRD patients receiving insulin for hyperkalemia treatment.

Outpatient Mineralocorticoid Receptor Antagonist Prescription Rate For Heart Failure, Svenja Schneider, Md, Sairamya Bodempudi, Md, Joshua Bernard, Md, Ryan D'Angelo, Pharmd, Eitan Frankel, Md, Sara Collins, Md, Yair Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement:

Improve MRA prescription rate in the outpatient cardiology clinic by 25%

Medication Safety In The Operating Room, Tzvi Grossman, Michael Glick, Alexandra Mulholland, Febina Padiyath, Fred Balzer

Health Equity and Quality Improvement (HEQI) Summit

The operating room is an area where a significant number of adverse drug events occur. Anesthesia providers administer potentially dangerous medications with very little oversight. We looked for a way to decrease the likelihood that a lethal dose of phenylephrine (10mg) would be given to a patient.

Perioperative Outcomes Of A Hydrocortisone Protocol After Endonasal Surgery For Pituitary Adenoma Resection, Tyler D. Alexander, Ms, Sarah Collopy, Michael Karsy, Md, Phd, Msc, Chandala Chitguppi, Md, Christopher J. Farrell, Md, James J. Evans, Md

Health Equity and Quality Improvement (HEQI) Summit

Adrenal insufficiency after transsphenoidal resection of pituitary adenoma (PA) can be seen in 1-12% of cases. In PA, the use of postoperative cortisol measurement and supplementation remains controversial. It is unclear whether postoperative cortisol supplementation has a measurable effect on improving outcomes in patients with pituitary adenoma undergoing endoscopic transsphenoidal surgery (ETS). The objective of the study was to evaluate a postoperative steroid treatment protocol in patients with PA undergoing ETS.

Perioperative Vte Chemical Prophylaxis At Jefferson Hospital: A Retrospective Review Of The Department Of Surgery, Walker Lyons, Md, Matthew Metzinger, Mba, Cphq, Tyler Grenda, Md, Craig Binney, Mba, Scott Cowan, Md

Health Equity and Quality Improvement (HEQI) Summit

Only 26.1% of patients are receiving perioperative VTE chemical prophylaxis for elective cases in the Department of Surgery

Utilization Of A Palliative Care Trigger In The Surgical Intensive Care Unit, Gillian Love, Md, Shawn Mangan, Msn, Rnfa, Anp-Bc, Agacnp-Bc, Michelle Mckay, Phd, Rn, Ccrn, Joshua Marks, Md, Facs, John Liantonio, Md, Mba, Hmdc

Health Equity and Quality Improvement (HEQI) Summit

• Our project aims to expand palliative care availability in the SICU by implementing a consult trigger program.
• We also aim to learn about and measure compassion fatigue of providers within the SICU.

Reforming The Pre-Operative Clearance Process In The Covid-19 Era, Ritam Ghosh, Md, René Daniel, Md, Jesse Edwards, Md, Catriona Harrop, Md, Janeen Duckworth, Msn, Amy Della Penna, Msn

Health Equity and Quality Improvement (HEQI) Summit

The problem at hand was increasing cancellation rates, increasing frustration amongst physicians, and lack of communication which guided our interventions

Some of the interventions used to improve the process are:

• PAT practioners routinely checking laboratory tests after the initial visit
• PAT practioners routinely documenting addendums in medical record in order to improve transparency and medical record
• Two step verification process: residents/surgeons going through medical record and communicating to PAT practioners if clearance was not ironclad
• Consulting physicians (i.e. cardiologists) with improved communication and documentation with PAT practioners in the event of additional testing necessary prior to clearance
• PAT physicians communicate …

Improving Time To Defibrillation At Thomas Jefferson University Hospital, Sairamya Bodempudi, Md, Lisa Wus, Dnp, Rn, Crnp, Pccn-Cmc, Juergen Kloo, Md, Patrick Zeniecki, Ma, Frances Mae West, Md, Yair Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Increase in timely defibrillation by 30% over 1 year
• Decrease in the amount of Vfib/VTach cardiac arrests that are not defibrillated to <1% within a 1 year time frame

Preventing Iatrogenic Pneumothorax “Just-In-Time”, Jason Ho, Md, Ammar Saati, Md, Ryan Commins, Md, Justin Henneman, Md, Frances Mae West, Md

Health Equity and Quality Improvement (HEQI) Summit

• In 2020 a high incidence of iatrogenic pneumothorax was noticed at TJUH after internal jugular central line insertion - Accepted rate is 0.1%
• With long periods of time between ICU rotations, residents suffer from significant procedural skill decay
• The COVID-19 pandemic brought with it an increase in the number of central lines placed
• During the COVID-19 pandemic, there has been a lack of large group training opportunities due to social distancing constraints

By December 31st 2021, our intervention will improve rates of iatrogenic pneumothorax after US-guided internal jugular central line insertion by 50% of baseline, as measured by chart review …

Mind The Gap: A Call For Attention At The Telemetry Station, N. Haroian, Md, T. Zivan, D. Frisch, A. Greenspon, Y. Lev, Md

Health Equity and Quality Improvement (HEQI) Summit

"Gaps" in telemetry recordings are a risk factor for patient identification errors and have led to near misses and adverse events in our hospital.

Goal: Completely eliminate wrongful telemetry data display by the end of the academic year.

Team-Based Outreach To Improve Colorectal Cancer Screening Rates In An Urban Family Medicine Practice, Alexa Waters, Md, Olivia Seecof, Md, Graham Stratton, Md, Caitlyn Haines, Md, Brittany Hozick, Md, Jose Medina, Md, Kathryn Topalis, Md, Hannah Facey, Md, Chelsea Salas-Tam, Md, David Peters, Md

Health Equity and Quality Improvement (HEQI) Summit

Aims for Improvement

• Aim to increase CRCS rates for our resident team patients by 5% by May, 2021
• Target Population (n=99): Age 50-74, due for CRCS, office visit within last 2 years, team resident listed as PCP, active on MyChart, and speak English

Adolescent And Young Adult Oncology Patient And Provider Perspectives In Philadelphia (Aya-4p), Christoher Terry, Md, Miriam Pomerantz, Lsw, Jodi Sandos, Lcsw, Lindsay Wilde, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objectives

• To assess the current perspective of AYA patients regarding medical services and psychosocial support delivered to AYAs in Philadelphia
• To assess the current knowledge and perspective of healthcare providers at the SKCC about the care and services needed by AYA patients