Medicine and Health Sciences Commons^™

Alcohol And Environmental Justice: The Density Of Liquor Stores And Bars In Urban Neighborhoods In The United States, John Romley, Deborah Cohen, Jeanne Ringel, Roland Sturm

Roland Sturm

Objective: This study had two purposes: (1) to characterize the density of liquor stores and bars that individuals face according to race, economic status, and age in the urban United States and (2) to assess alternative measures of retailer density based on the road network and population. Method: We used census data on business counts and sociodemographic characteristics to compute the densities facing individuals in 9,361 urban zip codes. Results: Blacks face higher densities of liquor stores than do whites. The density of liquor stores is greater among nonwhites in lower-income areas than among whites in lower- and higher-income areas …

Identifying Methods Nurse Managers Can Implement To Foster A Supportive Environment For Staff Where Disruptive Behavior Exists, Kathleen Leavitt

Critical and Creative Thinking Capstones Collection

We can all imagine the ideal work environment, where you are respected, empowered, and provided with the resources to perform to the best of your ability everyday. Your skills would be acknowledged and the challenging work that is accomplished each day would be appreciated by peers, team members, and managers. However, in my work environment, an operating room, a phenomenon called "disruptive behavior" often interrupts the ability of achieving this desired state. Initially I was focused on this behavior being displayed by physicians but was awakened to the fact that they are not the only offenders and that many caregivers …

Illness Stories: From Recognizing The Significance In Care To Planning My Own Storied Practice, Jane Lachance

Critical and Creative Thinking Capstones Collection

In this paper, stories of illness are identified as belonging to a specific genre of story that represents an ill person's interpretation of experience and hence the meaning(s) of illness. The ill person is recognized as member of a family embedded in a social setting with cultural mores that contribute to experience and meanings. The meaning of illness is significant because it affects the care of illness. This paper focuses on chronic illness, an illness without cure that is managed over a lifetime and is characterized by remission and exacerbation of symptoms. Our current bio-medical health care system reframes the …

Annual Report, 2006-2007, David B. Nash

College of Population Health Annual Reports

No abstract provided.

Healing The Health Care System: Summaries From The Department Of Health Policy Summer Seminar, David B. Nash, Nora Dowd Eisenhower, Rosemarie Greco, Deborah C. Meiris

College of Population Health Faculty Papers

Editorial Introduction:
The disease management field continues to evolve. The range of chronic diseases treated has expanded to include such conditions as obesity and pain management, and the care continuum now encompasses wellness, prevention, and population health. One population that is an ideal candidate for our collective efforts is that of older adults. Global and national population projections reveal the impending staggering increase in the age 65+ cohort, which will cause a sharp increase in the demand for health care and other services due to such age-related issues as multiple chronic conditions, falls, and depression.

To begin to address these …

Mice Deficient In Involucrin, Envoplakin, And Periplakin Have A Defective Epidermal Barrier., Lisa M Sevilla, Rachida Nachat, Karen R Groot, John F Klement, Jouni Uitto, Philippe Djian, Arto Määttä, Fiona M Watt

Department of Dermatology and Cutaneous Biology Faculty Papers

The cornified envelope is assembled from transglutaminase cross-linked proteins and lipids in the outermost epidermal layers and is essential for skin barrier function. Involucrin, envoplakin, and periplakin form the protein scaffold on which the envelope assembles. To examine their combined function, we generated mice deficient in all three genes. The triple knockouts have delayed embryonic barrier formation and postnatal hyperkeratosis (abnormal accumulation of cornified cells) resulting from impaired desquamation. Cornified envelopes form but are ultrastructurally abnormal, with reduced lipid content and decreased mechanical integrity. Expression of proteases is reduced and the protease inhibitor, serpina1b, is highly upregulated, resulting in defective …

The "Crossroads" And Beyond, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

A Novel Runx2 Missense Mutation Predicted To Disrupt Dna Binding Causes Cleidocranial Dysplasia In A Large Chinese Family With Hyperplastic Nails, Shaohua Tang, Qiyu Xu, Xueqin Xu, Jicheng Du, Xuemei Yang, Yusheng Jiang, Xiaoqin Wang, Nancy Speck, Taosheng Huang

Dartmouth Scholarship

Background: Cleidocranial dysplasia (CCD) is a dominantly inherited disease characterized by hypoplastic or absent clavicles, large fontanels, dental dysplasia, and delayed skeletal development. The purpose of this study is to investigate the genetic basis of Chinese family with CCD.

Methods: Here, a large Chinese family with CCD and hyperplastic nails was recruited. The clinical features displayed a significant intrafamilial variation. We sequenced the coding region of the RUNX2 gene for the mutation and phenotype analysis.

Results: The family carries a c.T407C (p.L136P) mutation in the DNA- and CBFβ-binding Runt domain of RUNX2. Based on the crystal structure, we predict this …

Report On The U.S. Summit: "Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management", Janice L. Clarke

College of Population Health Faculty Papers

On Tuesday, July 17, 2007 in Washington, DC, Intel Corporation assembled a group of the nation’s most respected health leaders to discuss the issues surrounding chronic care and an aging population and explore solutions to these highly complex and increasingly urgent challenges for the US health care system. The highlevel summit, hosted by Intel Chairman Craig Barrett, was held in the auditorium of the National Museum for Women in the Arts and attended, either in person or via the simultaneous webcast, by presidents, chairmen, and executive directors of influential organizations including the National Business Coalition on Health, the National Medical …

Periodontal Disease And Diabetes: Knowledge And Attitudes Assessment Project

Florida Public Health Review

There is a growing body of evidence showing that periodontal disease is more prevalent among diabetic patients than among non-diabetic patients. This same evidence also shows that the more poorly controlled the diabetes, the more severe the periodontal disease. However, it is unclear if the increased risk of periodontal disease is known by the diabetes community. Two hundred diabetic patients voluntarily participated in an intervention to increase the diabetic patient’s knowledge of and attitudes toward periodontal disease. The study was conducted at the University of Miami-Jackson Memorial Hospital’s Diabetes Research Institute (DRI) during the month of May 2005. The purpose …

Stem Cells: The Dawn Of A New Era For Huntington’S Disease Research, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Acetylation In Nuclear Receptor Signaling And The Role Of Sirtuins, Chenguang Wang, Michael J. Powell, Vladimir M. Popov, Richard G. Pestell

Department of Cancer Biology Faculty Papers

It has been known since the early 1970s that nuclear receptor complexes bind DNA in association with co-regulatory proteins. Characterization of these nuclear receptor coregulators has revealed diverse enzymatic activities which temporally and spatially coordinate nuclear receptor activity within the context of local chromatin in response to diverse hormone signals. Chromatin modifying proteins, which dictate the higher order chromatin structure in which DNA is packaged, in turn orchestrate orderly recruitment of nuclear receptor complexes. Modifications of histones include acetylation, methylation, phosphorylation, ubiquitylation, sumoylation, ADP ribosylation, deimination and proline isomerization (1). At this time, we understand how a subset of these …

How Does Quality Enter Into Health Care Purchasing Decisions?, Neil I. Goldfarb, Vittorio Maio, Chureen T. Carter, Laura Pizzi, David B. Nash

College of Population Health Faculty Papers

A number of employers, business consortia, and public purchasers are promoting "value-based purchasing" as a way to improve the quality of patient care. Some purchasers are using publicly available information on health plan and provider performance to make their health plan and provider choices, while others are using their market power to drive improvements in patient care and safety. This article examines six key strategies used by purchasers.

Editorial Board

Jefferson Journal of Psychiatry

No abstract provided.

Use Of Parthenolide Derivatives As Antileukemic And Cytotoxic Agents, Peter A. Crooks, Craig T. Jordan, Xiaochen Wei

Pharmaceutical Sciences Faculty Patents

Compounds of the formula having anti-tumor activity, wherein R₁ and R₂ are as described herein

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Penelope Susan Pekow

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Peter Lindenauer MD

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Myo1c Binds To Pip2 With High Affinity Through A Putative Ph Domain, David Hokanson

Publicly Accessible Penn Dissertations

Myo1c is a member of the myosin superfamily that links the dynamic actin cytoskeleton to the membrane, and plays roles in mechano-signal transduction and membrane trafficking. We located and characterized two distinct membrane binding sites within the regulatory and tail domains of this myosin. We found that the tail domain binds tightly and specifically to PIP2 in a non-cooperative manner. It binds with slightly higher affinity to Ins(1,4,5)P3 as well as other inositol phosphates which may act as inhibitors to membrane binding in the cell. By sequence and secondary structure analysis, we identified this phosphatidylinositol binding site in the tail …

Repeated N-Acetylcysteine Administration Alters Plasticity-Dependent Effects Of Cocaine, Aric Madayag, Doug Lobner, Kristen S. Kau, John R. Mantsch, Omer Abdulhameed, Matthew Hearing, Mark D. Grier, David A. Baker

Biomedical Sciences Faculty Research and Publications

Cocaine produces a persistent reduction in cystine–glutamate exchange via system x_c− in the nucleus accumbens that may contribute to pathological glutamate signaling linked to addiction. System x_c− influences glutamate neurotransmission by maintaining basal, extracellular glutamate in the nucleus accumbens, which, in turn, shapes synaptic activity by stimulating group II metabotropic glutamate autoreceptors. In the present study, we tested the hypothesis that a long-term reduction in system x_c− activity is part of the plasticity produced by repeated cocaine that results in the establishment of compulsive drug seeking. To test this, the cysteine prodrug N-acetylcysteine …

Towards An Understanding Of Salient Neighborhood Boundaries: Adolescent Reports Of An Easy Walking Distance And Convenient Driving Distance, Natalie Colabianchi, Marsha Dowda, Karin A. Pfeiffer, Dwayne E. Porter, Maria João C. A. Almeida, Russell R. Pate

Faculty Publications

Numerous studies have examined the association between the surrounding neighborhood environment and physical activity levels in adolescents. Many of these studies use a road network buffer of Euclidean distance buffer around an adolescent's home to represent the appropriate geographic area for study (i.e., neighborhood). However, little empirical research has examined the appropriate buffer size to use when defining this area and there is little consistency across published research as to the buffer size used. In this study, 909 12^th grade adolescent girls of diverse racial and geographic backgrounds were asked to report their perceptions of an easy walking distance …

Common And Distinct Mechanisms Of Different Redox-Active Carcinogens Involved In The Transformation Of Mouse Jb6p+ Cells, Sun Yang, Bobbye J. Misner, Rita Chiu, Frank L. Meyskens Jr.

Pharmacy Faculty Articles and Research

We transformed JB6P+ cells with prolonged intermittent low-dose UVB radiation or prolonged exposure to low-dose H2O2 or CdCl2. Stable transformation was confirmed by an anchorage-independence assay. The JB6P+ transformants formed more colonies (∼six folds) in soft agar as compared to their JB6P+ parent cells and were associated with increased intracellular reactive oxygen species (ROS) levels. Activating protein-1 (AP-1) is a family of transcription factors that are rapidly activated by elevated intracellular ROS levels, and their composition is important in the process of cellular transformation and/or tumor progression. To investigate if carcinogenesis induced by distinct carcinogens was via similar molecular mechanisms …

Short-Wavelength Light Sensitivity Of Circadian, Pupillary, And Visual Awareness In Humans Lacking An Outer Retina, Farhan H. Zaidi, Joseph T. Hull, Stuart N. Peirson, Katharina Wulff, Daniel Aeschbach, Joshua J. Gooley, George C. Brainard, Kevin Gregory-Evans, Joseph F. Rizzo Iii, Charles A. Czeisler, Russell G. Foster, Merrick J. Moseley, Steven W. Lockley

Department of Neurology Faculty Papers

As the ear has dual functions for audition and balance, the eye has a dual role in detecting light for a wide range of behavioral and physiological functions separate from sight. These responses are driven primarily by stimulation of photosensitive retinal ganglion cells (pRGCs) that are most sensitive to short-wavelength ( approximately 480 nm) blue light and remain functional in the absence of rods and cones. We examined the spectral sensitivity of non-image-forming responses in two profoundly blind subjects lacking functional rods and cones (one male, 56 yr old; one female, 87 yr old). In the male subject, we found …

Evidence-B(I)Ased Medicine: Limitations And Non-Superstition-Based Alternatives, Joshua S. Green M.D., Ph.D. (Pgy4)

Jefferson Journal of Psychiatry

The Evidence-Based Medicine (EBM) movement crystallized in the early 1990's at McMaster University in Canada. The movement originally challenged practitioners to validate their treatments based on reasoning and clinical studies rather than personal authority. In this essay, I will argue that, contrary to this wholesome intention, EBM is authoritarian in spirit and actually constricts discourse about how to make clinical decisions.

Diphenhydramine-Dependence Resulting From Self-Medication Of Antipsychotic- Induced Extrapyramidal Symptoms, Faisal S. Shaikh M.B.B.S., Ann M. Mortimer M.D.

Jefferson Journal of Psychiatry

Antipsychotic-induced extrapyramidal symptoms should be recognised and adequately treated. We report an unusual complication of not doing so: a patient’s self-medicating to control these symptoms, which produced diphenhydramine-dependence.

Dissociative-Like Spells In A Child With Neurofibromatosis (Type 1), Gregory M. Singleton M.D. (Pgy2), Ann M. Lagges Ph.D., Karen G. Meighen M.D.

Jefferson Journal of Psychiatry

Neurofibromatosis, type 1, (NF1) is a common neurocutaneous disorder of childhood. Little is known about the psychiatric aspects of the condition. We present the case of a 10-year-old male with NF1 and complex spells. For two years he had been experiencing self-limited paroxysms of auditory and visual hallucination, assaultiveness, excited undressing, and amnesia. The spells have been refractory to multiple treatments, including antipsychotic medication. The question remains whether this episodic amnestic disorder is comorbid with NF1 or is caused by it.

A Major Event Of Self-Mutilation In A Patient With Fetal Alcohol Syndrome, Joel P. Johnson M.D. (Pgy4), Steven Sugden M.D., James A. Bourgeois O.D., M.D.

Jefferson Journal of Psychiatry

We describe a young adult male with fetal alcohol syndrome (FAS) who presented with a non-repetitive, major, genital self-mutilation necessitating urological intervention. On formal psychiatric evaluation, he did not have psychosis or suicidality. Most commonly, self-injury in developmental disability is less severe and more stereotypic; major-class self-mutilation is confined, generally, to psychosis. It is this discrepancy that is the unusual feature of our case.

Autocastration And Autoamputation Of The Penis In A Patient With Delusions Of Sexual Guilt, Craig B. Franke M.D. (Pgy4), James A. Rush M.D. (Pgy3)

Jefferson Journal of Psychiatry

Genital self-mutilation (GSM) is a rare event that is commonly associated with psychotic disorders; we report an occurrence in the context of psychosis and drug use. We also review the etiologies of this phenomenon and how these etiologies differ across gender.

Clozapine, Fluoxetine, And Benztropine- Associated Ileus: Case Report, Pegah Pajouhi M.D. (Pgy1), James A. Bourgeois O.D., M.D.

Jefferson Journal of Psychiatry

Gastrointestinal complications of anticholinergic medications are prevalent, potentially life-threatening, and could be more actively prevented. We present a case report of an ileus that required surgical intervention and developed in the context of clozapine, benztropine, and fluoxetine use. The case exemplifies the potential anticholinergic toxicities of clozapine and benztropine as well as possible pharmacokinetic interactions between fluoxetine, clozapine, and benztropine. We discuss ways to minimize the likelihood of anticholinergic complications with these medications.

Oral Immunization Of Rhesus Macaques With Adenoviral Hiv Vaccines Using Enteric-Coated Capsules, George T. Mercier, Pramod N. Nehete, Marco F. Passeri, Bharti N. Nehete, Eric A. Weaver, Nancy Smyth Templeton, Kimberly Schluns, Stephanie S. Buchl, K. Buchl, Michael A. Barry

Virology Papers

Targeted delivery of vaccine candidates to the gastrointestinal (GI) tract holds potential for mucosal immunization, particularly against mucosal pathogens like the human immunodeficiency virus (HIV). Among the different strategies for achieving targeted release in the GI tract, namely the small intestine, pH sensitive enteric coating polymers have been shown to protect solid oral dosage forms from the harsh digestive environment of the stomach and dissolve relatively rapidly in the small intestine by taking advantage of the luminal pH gradient. We developed an enteric polymethacrylate formulation for coating hydroxy-propyl-methyl-cellulose (HPMC) capsules containing lyophilized Adenoviral type 5 (Ad5) vectors expressing HIV-1 gag …

Implementing Pharmacy Informatics In College Curricula: The Aacp Technology In Pharmacy Education And Learning Special Interest Group, Ross E. Vanderbush, H. Glenn Anderson Jr., William K. Fant, Brad S. Fujisaki, Patrick M. Malone, Paul L. Price, Maria C. Pruchnicki, Teresa L. Sterling, Kara D. Weatherman, Karl G. Williams

Pharmacy Practice & Administration

Many professional organizations have initiatives to increase the awareness and use of informatics in the practice of pharmacy. Within education we must respond to these initiatives and make technology integral to all aspects of the curriculum, inculcating in students the importance of technology in practice. This document proposes 5 central domains for organizing planning related to informatics and technology within pharmacy education. The document is intended to encourage discussion of informatics within pharmacy education and the implications of informatics in future pharmacy practice, and to guide colleges of pharmacy in identifying and analyzing informatics topics to be taught and methods …