Medicine and Health Sciences Commons^™

Establishing Roots In West Philadelphia, Nina Millman, James Larosa, Skip Weiner, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Urban Tree Connection

Urban Tree Connection is an organization that utilizes plots of land which have been abandoned. The organization uses the land to create gardens that grow produce which is then sold at markets and to the community. Their goal is to provide access to fresh fruits and vegetables in the food desert areas of West Philadelphia. Members of the community are able to get involved by allowing some of their land to be used as gardens and helping to maintain the sites. The organization also tries to spread information about sustainability including a compost program in the neighborhood.

Regional Disparities In Neurocritical Care Outcomes, Kali Graham

CwiC-PH

BACKGROUND

• Determinants of Neurocritical Care Outcomes: Social as opposed to biological disparities can frequently dictate health outcomes for neurocritically ill patients. Survival rates are determined both by a patient’s access to a NCU (Neurocritical Care Unit) as well as the level of inpatient care he or she receive once admitted to a NCU.
• Regional Inequality in Access to Care¹:
• Only 12.8% of Americans have access to a NCU within 45 min by ground transportation and 36.8% have access to a NCU within 45 minutes by air transportation.
• Racial Disparities in NCU Admissions and Outcomes²:
• Non …

Direct From The Students: Ideas To Improve Diversity Education At Sidney Kimmel Medical College, Elizabeth Sophy, Ms2, Christine Jerback, Md, Natasha Brown, Edd, Ms

CwiC-PH

The Importance of Diversity

Diversity in medical education:

• Enhances students’ educational experience⁸
• Influences perspectives about culture, health, and about social issues³

Diversity in clinical practice:

• Decreases health disparities and improves outcomes³
• Increases patient satisfaction⁵
• Increases access for underserved^4,7

Heart Failure In Hispanic Americans: Improving Cultural Awareness, Kenneth D. Melton, Karen J. Fell, Karen S. Yehle, Rosanne R. Griggs

School of Nursing Faculty Publications

Hispanic Americans are the largest and fastest growing ethnic group in the United States. Hispanic Americans have high rates of heart failure (HF) risk factors, such as hypertension, diabetes mellitus, obesity, obstructive sleep disorders, and dyslipidemia. Certain unique HF risk factors prominent among Hispanic Americans are uncommon in the general population, such as younger onset of valvular disease and Chagas disease. Advanced practice nurses providing care to Hispanic Americans have an ethical obligation to provide culturally competent care and assist these patients in overcoming barriers to health care so that they can effectively manage their HF.

The Role Of Parental Cognitive, Behavioral, And Motor Profiles In Clinical Variability In Individuals With Chromosome 16p11.2 Deletions, Andres Moreno-De-Luca, David W. Evans, K B. Boomer, Ellen Hanson, R Bernier, R. P. Goin-Kochel, S. M. Myers, Thomas D. Challman, Daniel Moreno-De-Luca, Mylissa M. Slane, Abby E. Hare, W K. Chung, J. Spiro, W. A. Faucett, C. L. Martin, David H. Ledbetter

Faculty Journal Articles

Importance Most disorders caused by copy number variants (CNVs) display significant clinical variability, often referred to as incomplete penetrance and variable expressivity. Genetic and environmental sources of this variability are not well understood.

Objectives To investigate the contributors to phenotypic variability in probands with CNVs involving the same genomic region; to measure the effect size for de novo mutation events; and to explore the contribution of familial background to resulting cognitive, behavioral, and motor performance outcomes in probands with de novo CNVs.

Design, Setting, and Participants Family-based study design with a volunteer sample of 56 individuals with de novo 16p11.2 …

Francis Daniels Moore: One Of The Brightest Minds In The Surgical Field., Sara L. Low, Bs, Charles J. Yeo, Md, Scott W. Cowan, Md, Ashesh P. Shah, Md

Department of Surgery Gibbon Society Historical Profiles

Francis Daniels Moore was a pioneer ahead of his time who made numerous landmark contributions to the field of surgery, including the understanding of metabolic physiology during surgery, liver and kidney transplant, and the famous Study on Surgical Services of the United States (SOSSUS) report of 1975 that served for decades as a guideline for development of surgical residencies. He was the epitome of what a physician should be, a compassionate and dedicated surgeon, innovative scientist, and a medical professional dedicated to quality medical education across all specialties.

Vivien Thomas: Master Craftsman, Gifted Teacher, And Unsung Hero., Alisha Joyner, B.S., Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

The field of pediatric cardiovascular surgery gained international recognition in 1944 with the first successful correction of a tetralogy of Fallot congenital anomaly in a 15-month-old patient. Dr. Helen Taussig (1898 to 1986), a pediatrician at Johns Hopkins Hospital, recognized the need for the procedure. Dr. Alfred Blalock (1899 to 1964), Chief of Surgery at Johns Hopkins Hospital, is credited with performing the surgery. However, there is an unsung hero who for many years did not receive a single mention in the medical literature. Vivien Thomas (1910 to 1985) was Dr. Blalock’s research assistant who is said to have stood …

The Artificial Divide Between Biomedical Sciences And Clinical Medicine In Undergraduate Medical Education, Abdul Rehman, Noor Ul-Ain Baloch, Muhammad Awais

Department of Biological & Biomedical Sciences

No abstract provided.

Open Letter On Shaken Baby Syndrome And Courts: A False And Flawed Premise, Bill Bache, Patrick Barnes, Beverly Beech, Flo Bellone, Thomas L. Bohan, Harry J. Bonnell, Marta Cohen, D. L. Contostavlos, Peter Dale, Lina Davidson, Steven Gabaeff, Horace Gardner, Margaret Gardner, Jean Golding, A. N. Guthkelch, Charles M. Harvey, Helen Hayward-Brown, John Hemming, John C. Hunsaker Iii, Charles Hyman, Jan Leestma, James Lefanu, John Lloyd, Marvin E. Miller, Catherine Mills, George R. Nichols Ii, Michael Nott, John Plunkett, Charles Pragnell, Jean Robinson, Robert K. Rothfeder, Irene Scheimberg, Ron Uscinski, Michael Weinraub, Ed Willey, R. K. Wright, Lynne Wrennall

Pediatrics Faculty Publications

The Open Letter on Shaken Baby Syndrome and Courts has been prepared under the auspices of the International Public Health Research Group [IPHRG]. It was developed from initial drafts by Bill Bache and Charles Pragnell. Final drafting and editing was by Dr Lynne Wrennall, Executive Director of the International Public Health Research Group and the Managing Editor of Argument & Critique. The process of writing the letter has relied on the published research in the field, much of it, published research by the signatories to the letter. The process has also drawn on the iterative contribution of insights by the …

The Effectiveness Of Whole-Body-Vibration Training In Improving Hamstring Flexibility In Physically Active Adults, Megan N. Houston, Victoria Hodson, Kelda K. E. Adams, Johanna M. Hoch

Human Movement Studies & Special Education Faculty Publications

Clinical Scenario: Hamstring tightness is common among physically active individuals. In addition to limiting range of motion and increasing the risk of muscle strain, hamstring tightness contributes to a variety of orthopedic conditions. Therefore, clinicians continue to identify effective methods to increase flexibility. Although hamstring tightness is typically treated with common stretching techniques such as static stretching and proprioceptive neuromuscular facilitation, it has been suggested that whole-body-vibration (WBV) training may improve hamstring flexibility. Clinical Question: Can WBV training, used in isolation or in combination with common stretching protocols or exercise, improve hamstring flexibility in physically active young adults? Summary of …

Oncolog, Volume 60, Number 02, February 2015, Sarah Bronson, Bryan Tutt, N. Danckers

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Natural Killer Cell Therapy May Augment Treatment of Hematological Cancers: Tough cancer treatments can severely weaken the body's natural ability to attack cancer cells. To improve immune recovery and function in patients who have undergone these treatments, especially those who may later receive a stem cell transplant, researchers are turning to natural killer cells that have been expanded in the laboratory.
• Concurrent Treatment of HIV and Cancer Improves Survival Outcomes: Concurrent HIV and cancer present special challenges in the clinic, regardless of which disease is diagnosed first. The simultaneous treatment of HIV and cancer is complicated by patients' weakened immune …

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Department of Public Health Scholarship and Creative Works

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

No Rush To Motherhood: The Lived Experience Of African American Never Pregnant Sexually Active Female Teens, Monique Jenkins

Dissertations, Theses, and Capstone Projects

The purpose of this study was to explore the experiences of sexually active never pregnant African American female adolescents living in an underserved neighborhood including discussions on their thoughts about ways other teens can similarly avoid pregnancy. The study was conducted using a Hermeneutic phenomenological qualitative approach as described and outlined by Merleau-Ponty as well as the van Manen technique to analyze data obtained in this study. This study contributes to the nursing literature and was conducted to understand the essence and meaning of pregnancy avoidance as experienced by sexually active, never pregnant African American female teens within the context …

The Neurophysiology Of Intersensory Selective Attention And Task Switching, Jeremy W. Murphy

Dissertations, Theses, and Capstone Projects

Our ability to selectively attend to certain aspects of the world and ignore others is fundamental to our day-to-day lives. The need for selective attention stems from capacity limitations inherent in our perceptual and cognitive processing architecture. Because not every elemental piece of our environment can be fully processed in parallel, the nervous system must prioritize processing. This prioritization is generally referred to as selective attention. Meanwhile, we are faced with a world that is constantly in flux, such that we have to frequently shift our attention from one piece of the environment to another and from one task to …

Coercing Pregnancy, A. Rachel Camp

William & Mary Journal of Race, Gender, and Social Justice

Intimate partners coerce thousands of women in the United States into pregnancy each year through manipulation, threats of violence, or acts that deliberately interfere with the use of, or access to, contraception or abortion. Although many of these pregnancies occur within the context of otherwise abusive relationships, for others, pregnancy serves as a trigger for intimate partner violence. Beyond violence preceding or resulting from pregnancy, women who experience coerced pregnancies often suffer other physical, financial and emotional harms. Despite its correlation to domestic violence, reproductive coercion fits imperfectly, if at all, within our existing laws designed to combat domestic violence …

Closed Cases? - The Mentioning Of Medical Errors In Doctors' Memoirs, Angelika Potempa

Philosophy Faculty Publications

The concession of errors in the pursuit of the art of medicine, where mishaps can lead to deleterious consequences is at the center of this paper. The social costs of medical errors and a professional culture with a strong tradition of self-regulation and shielding itself via a more or less permeable “Wall of Silence” make the issue not only interesting but keep it timely. The focus is on how and within what framework medical errors are admitted in the memoirs of American doctors. The times remembered reach from the 1950s and 1960s to the present.

Utility Of Ultrasound For Imaging Osteophytes In Patients With Insertional Achilles Tendinopathy, Ruth L. Chimenti, Peter C. Chimenti, Mark R. Buckley, Jeff R. Houck, A. Samuel Fleminster

Faculty Publications - College of Physical Therapy

Objectives: To examine (1) the validity of ultrasound imaging to measure osteophytes and (2) the association between osteophytes and insertional Achilles tendinopathy (IAT).

Design: Case-control study.

Setting: Academic medical center.

Participants: Persons with chronic unilateral IAT (n=20; mean age, 58.7±8.3y; 10 [50%] women) and age- and sex-matched controls (n=20; mean age, 57.4±9.8y; 10 [50%] women) participated in this case-control study (N=40).

Interventions: Not applicable.

Main Outcome Measures: Symptom severity was assessed using the Foot and Ankle Ability Measure, the Victorian Institute of Sport Assessment-Achilles questionnaire, and the numerical rating scale. Length of osteophytes was measured bilaterally in both groups using …

Price Subsidies, Diagnostic Tests, And Targeting Of Malaria Treatment: Evidence From A Randomized Controlled Trial, Jessica Cohen, Pascaline Dupas, Simone Schaner

Dartmouth Scholarship

Both under- and over-treatment of communicable diseases are public bads. But efforts to decrease one run the risk of increasing the other. Using rich experimental data on household treatment- seeking behavior in Kenya, we study the implications of this trade-off for subsidizing life-saving antimalarials sold over-the-counter at retail drug outlets. We show that a very high subsidy (such as the one under consideration by the international community) dramatically increases access, but nearly one-half of subsidized pills go to patients without malaria. We study two ways to better target subsidized drugs: reducing the subsidy level, and introducing rapid malaria tests over-the-counter. …

A Coming Disruption In Pharmacy?, Frank Romanelli, Timothy S. Tracy

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Pregnant, Even When You Did Not Want To Be Pregnant, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Self-Perceived Barriers To Eye Care In A Hard-To-Reach Population: The Karachi Marine Fishing Communities Eye And General Health Survey, Khabir Ahmad, Anthony B. Zwi, Daniel J. M. Tarantola, Tanveer Anjum Chaudhry

Department of Surgery Docs

Abstract

Purpose.: We examined self-reported barriers to eye care among marginalized, hard-to-reach fishing communities in Karachi, Pakistan.

Methods.: The Karachi Marine Fishing Communities Eye and General Health Survey was a cross-sectional survey conducted between March 2009 and April 2010 in fishing communities in Keamari, Karachi, located on the coast of the Arabian Sea. Adults aged ≥50 years living on seven islands and coastal areas were interviewed regarding sociodemographic background, experience of eye problems, eye care use, and barriers to access. They also were examined to determine visual acuity with a reduced logMAR chart and underwent a detailed eye examination.

Results.: …

Unlv School Of Medicine Return On Investment To The State General Fund, Tripp Umbach, Lincy Institute

Lincy Institute Reports and Briefs

Economic activity in the State of Nevada’s economy from the spending of the UNLV School of Medicine will remain inside the state as well as fresh dollars that will flow inside the state because the medical school will generate general fund revenue through a wide variety of taxes. Tripp Umbach estimates that every fresh dollar in economic impact from the UNLV School of Medicine will generate 4.9% in state general fund revenue. As the UNLV School of Medicine matures, the Return on Investment (ROI) to the State of Nevada’s economy will grow.

African American Men With Low-Grade Prostate Cancer Have Increased Disease Recurrence After Prostatectomy Compared With Caucasian Men., Kosj Yamoah, Curtiland Deville, Neha Vapiwala, Elaine Spangler, Charnita M. Zeigler-Johnson, Bruce Malkowicz, David I Lee, Michael Kattan, Adam P. Dicker, Timothy R. Rebbeck

Department of Radiation Oncology Faculty Papers

PURPOSE: To explore whether disparities in outcomes exist between African American (AA) and Caucasian (CS) men with low-grade prostate cancer and similar cancer of the prostate risk assessment-postsurgery (CAPRA-S) features following prostatectomy (RP).

METHODS: The overall cohort consisted of 1,265 men (234 AA and 1,031 CS) who met the National comprehensive cancer network criteria for low- to intermediate-risk prostate cancer and underwent RP between 1990 and 2012. We first evaluated whether clinical factors were associated with adverse pathologic outcomes and freedom from biochemical failure (FFbF) using the entire cohort. Next, we studied a subset of 705 men (112 AA and …

Overboard Falls Of Crew Members On Québec Lobster Boats: Risk Analysis And Prevention Solutions, Sylvie Montreuil, Francis Coulombe, Jean-Guy Richard, Michel Tremblay

Rapports de recherche scientifique

L’activité de pêche commerciale est l’une des plus dangereuses du domaine industriel. Des chutes par-dessus bord se produisent chaque saison de pêche et leurs conséquences sont généralement graves, parfois mortelles. Au cours des dernières années, deux décès sont survenus dans ces circonstances au Québec lors d’activités de pêche au homard. De façon générale les causes documentées des chutes par-dessus bord sont la perte d’équilibre et l’entraînement par le gréement de pêche. Les objectifs de cette recherche sont : 1) d’analyser les risques de chute par-dessus bord et leurs déterminants lors de la pêche au homard, 2) de documenter les moyens …

Challenges Of Green Jobs In Quebec's Photovoltaic Industry, Bouchra Bakhiyi, Joseph Zayed

Rapports de recherche scientifique

L’industrie du photovoltaïque (PV), pourvoyeuse d’électricité solaire à faible empreinte écologique, est un secteur d’activité en pleine croissance ayant généré quelque 220 000 emplois verts dans le monde en 2010, avec une projection de près de 2 000 000 à l’horizon 2020. L'industrie du photovoltaïque fait face néanmoins à des risques potentiels pour la santé et la sécurité des travailleurs et ce, tout le long du cycle de vie des systèmes photovoltaïques. L’objectif général de cette recherche était de dresser un portrait de l’industrie du PV au Québec. Elle visait plus précisément à : 1) réaliser le bilan de la …

Effects Of Three Dry Powder Inhalers On Deposition Of Aerosolized Medicine In The Human Oral-Pharyngeal-Laryngeal Regions, Mohammed Ali

Technology Faculty Publications and Presentations

The dry powder inhaler (DPI) is a popular, effective and convenient drug delivery device for inhalation therapy to treat asthma. However, a large quantity (approximately 54%) of inhaled aerosols deposit in the oropharyngeal region. Deposition in this region is undesirable because it provides minimum therapeutic benefits and has adverse localized or systemic side effects. This study reports a method of examining electrostatic charge effects on deposition of three DPI aerosols (Spiriva^™ Handihaler, Advair Diskus^™, and Pulmicort^™ Turbohaler) in a cadaver-based cast of the human oral-pharyngeal-laryngeal (OPL) regions. Experimental aerosols were generated from the three commercially available …

Factors Affecting The Pharmacokinetics And Pharmacodynamics Of Pegylated Liposomal Irinotecan (Ihl-305) In Patients With Advanced Solid Tumors, Huali Wu, Jeffrey R. Infante, Vicki L. Keedy, Suzanne F. Jones, Emily Chan, Johanna C. Bendell, Wooin Lee, Whitney P. Kirschbrown, Beth A. Zamboni, Satoshi Ikeda, Hiroshi Kodaira, Mace L. Rothenberg, Howard A. Burris, William C. Zamboni

Pharmaceutical Sciences Faculty Publications

IHL-305 is a PEGylated liposomal formulation of irinotecan (CPT-11). The objective of this study was to evaluate the factors associated with interpatient variability in the pharmacokinetics and pharmacodynamics of IHL-305 in patients with advanced solid tumors. IHL-305 was administered intravenously once every 4 weeks as part of a Phase I study. Pharmacokinetic studies of the liposomal sum total CPT-11, released CPT-11, SN-38, SN-38G, 7-ethyl-10-[4-N-(5-aminopentanoic acid)-1-piperidino]-carbonyloxycamptothecin, and 7-ethyl-10-[4-amino-1-piperidino]-carbonyloxycamptothecin in plasma were performed. Noncompartmental and compartmental pharmacokinetic analyses were conducted using pharmacokinetic data for sum total CPT-11. The pharmacokinetic variability of IHL-305 is associated with linear and nonlinear clearance. Patients whose age …

Managing Opportunities And Challenges Of Co-Authorship, Vicki S. Conn, Sandra Ward, Linda Herrick, Robert V. Topp, Gregory L. Alexander, Cindy M. Anderson, Carol E. Smith, Lazelle E. Benefield, Barbara Given, Marita Titler, Janet L. Larson, Nancy L. Fahrenwald, Marlene Z. Cohen, Sharlene Georgesen

College of Nursing Faculty Research and Publications

Research with the largest impact on practice and science is often conducted by teams with diverse substantive, clinical, and methodological expertise. Team and interdisciplinary research has created authorship groups with varied expertise and expectations. Co-authorship among team members presents many opportunities and challenges. Intentional planning, clear expectations, sensitivity to differing disciplinary perspectives, attention to power differentials, effective communication, timelines, attention to published guidelines, and documentation of progress will contribute to successful co-authorship. Both novice and seasoned authors will find the strategies identified by the Western Journal of Nursing Research Editorial Board useful for building positive co-authorship experiences.

Novel Approach To Identify Optimal Metabotypes Of Elongase And Desaturase Activities In Prevention Of Acute Coronary Syndrome, Nathan L. Tintle, John W. Newman, Gregory C. Shearer

Faculty Work Comprehensive List

Both metabolomic and genomic approaches are valuable for risk analysis, however typical approaches evaluating differences in means do not model the changes well. Gene polymorphisms that alter function would appear as distinct populations, or metabotypes, from the predominant one, in which case risk is revealed as changed mixing proportions between control and case samples. Here we validate a model accounting for mixed populations using biomarkers of fatty acid metabolism derived from a case/control study of acute coronary syndrome subjects in which both metabolomic and genomic approaches have been used previously. We first used simulated data to show improved power and …

Knowledge Base Of Adolescents With Congenital Heart Disease, Mark Gelatt, Julie Martin, Jennifer A. Marshall, Jennifer Panuco, Jenea Schmidt, Pamela Finn

Posters

Introduction:

Most congenital heart disease [CHD] is diagnosed and treated in early childhood with parents responsible for decision-making. The adolescent assumes this role in preparation for transition to an adult congenital heart program. We studied the knowledge base of our adolescent CHD patients and their parents.

Methods:

Established CHD patients, >11 y.o. and their parents, were independently surveyed in the outpatient clinic. Participation was voluntary. Cardiomyopathy, electrophysiology and transplant patients were excluded. Scores were assessed as full, partial or incomplete.

Results:

Most (98% parents; 83% adolescents) reported that their cardiologist had provided education. Adolescents provided a full (49%) and partial …