Medicine and Health Sciences Commons^™

Physician Executive Leadership (Pel): Expanding Medical School Leadership And Management Education, Gavyn Ooi, Mba, Audra Hugo, Eric Shiuey, Stephanie Beldick, Aaron Bholé, Andrew Lee, Chris Li, Michael Morano, Julia Tonnessen, Michael Zimmerman

Student Papers, Posters & Projects

Today’s doctors are expected to fulfill many roles, and yet, traditional medical education does not include the following:

• Interdisciplinary teamwork
• Leadership skills
• Management and business techniques
• Financial knowledge
• Quality improvement
• Information technology
• Systems based approaches

Physician Executive Leadership (PEL) was founded in 2013 at Jefferson’s Sidney Kimmel Medical School to directly address gaps in medical education The PEL curriculum is both student run and student led, informed by student demand and feedback Students can complete the curriculum at the standard level of commitment or be more engaged to earn Distinction The PEL curriculum is centered around six pillars:

• Applied Leadership …

Induction Techniques That Reduce Redistribution Hypothermia: A Prospective, Randomized, Controlled, Single Blind Effectiveness Study., Jonathan V. Roth, Leonard E. Braitman, Lacy H. Hunt

Student Papers, Posters & Projects

BACKGROUND: While much effort has been devoted to correcting intraoperative hypothermia, less attention has been directed to preventing redistribution hypothermia. In this study, we compared three different anesthetic induction techniques to standard IV propofol inductions (control) in their effect on reducing redistribution hypothermia.

METHODS: Elective, afebrile patients, age 18 to 55 years, were randomly assigned to one of four groups (n = 50 each). Group "INH/100" was induced with 8% sevoflurane in 100% oxygen, Group "INH/50" with 8% sevoflurane in 50% oxygen and 50% nitrous oxide, Group "PROP" with 2.2 mg/kg propofol, and Group "Phnl/PROP" with 2.2 mg/kg propofol immediately …

Developing A Community-Based Research Project Proposal To Build Public Health Educator Capacity: A Graduate Student Perspective., Alexander J. Baukus

Student Papers, Posters & Projects

This article is the author's first-person perspective of completing an Applied Practice Experience (APE) at an accredited public health program. Graduate-level public health students in the United States are mandated by the Council on Education for Public Health to complete this supervised field experience to apply knowledge and concepts to real-world public health practice. For his APE, the author worked with a faculty advisor and two community groups to facilitate and submit a community-based participatory research grant proposal. This article discusses the author's experiences before, during, and after the APE. The author outlines challenges and success of working on this …

Post-Stroke Recrudescence In The Setting Of Tramadol Overuse: A Case Report, Richard S. Zhang, Bs, Benjamin Larson, Md

Student Papers, Posters & Projects

This report promotes greater awareness of opioid-induced PSR, especially considering the tragic opioid crisis that has afflicted the US since the 1990s, and the contribution of synthetic prescription opioids to the crisis. This report also supports the establishment of care guidelines to limit PSR risk in people with major risk factors, such as MCA infarcts.

Variable Levels Of Drift In Tunicate Cardiopharyngeal Gene Regulatory Elements., William Colgan, Alexis Leanza, Ariel Hwang, Melissa B. Debiasse, Isabel Llosa, Daniel Rodrigues, Hriju Adhikari, Guillermo Barreto Corona, Saskia Bock, Amanda Carillo-Perez, Meagan Currie, Simone Darkoa-Larbi, Daniel Dellal, Hanna Gutow, Pascha Hokama, Emily Kibby, Noah Linhart, Sophia Moody, Allison Naganuma, Diep Nguyen, Ryan Stanton, Sierra Stark, Cameron Tumey, Anthony Velleca, Joseph F. Ryan, Brad Davidson

Student Papers, Posters & Projects

Background: Mutations in gene regulatory networks often lead to genetic divergence without impacting gene expression or developmental patterning. The rules governing this process of developmental systems drift, including the variable impact of selective constraints on different nodes in a gene regulatory network, remain poorly delineated.

Results: Here we examine developmental systems drift within the cardiopharyngeal gene regulatory networks of two tunicate species, Corella inflata and Ciona robusta. Cross-species analysis of regulatory elements suggests that trans-regulatory architecture is largely conserved between these highly divergent species. In contrast, cis-regulatory elements within this network exhibit distinct levels of conservation. In particular, while most …

Continuous Aspiration Mechanical Thrombectomy For Tissue Diagnosis Of Indeterminate Inferior Vena Cava Thrombus, Varun Singh, Christopher Molloy, Md, Geogy Vatakencherry, Md

Student Papers, Posters & Projects

Purpose

To illustrate the utility of a continuous aspiration mechanical thrombectomy catheter in the tissue-proven determination and retrieval of hepatocellular carcinoma (HCC) tumor thrombus in the inferior vena cava (IVC ) of a 61 year-old non-cirrhotic male with Hepatitis C on ledipasvir/sofosbuvir therapy and hepatic segment VIII lesion with right atrial invasion

Comparing Record Linkage Software Programs And Algorithms Using Real-World Data., Alan F. Karr, Matthew T. Taylor, Suzanne L. West, Soko Setoguchi, Tzuyung D. Kou, Tobias Gerhard, Daniel B. Horton

Student Papers, Posters & Projects

Linkage of medical databases, including insurer claims and electronic health records (EHRs), is increasingly common. However, few studies have investigated the behavior and output of linkage software. To determine how linkage quality is affected by different algorithms, blocking variables, methods for string matching and weight determination, and decision rules, we compared the performance of 4 nonproprietary linkage software packages linking patient identifiers from noninteroperable inpatient and outpatient EHRs. We linked datasets using first and last name, gender, and date of birth (DOB). We evaluated DOB and year of birth (YOB) as blocking variables and used exact and inexact matching methods. …

Development Of An Outpatient Palliative Care Protocol To Monitor Fidelity In The Emergency Medicine Palliative Care Access Trial., Corita R. Grudzen, Abigail M. Schmucker, Deborah J. Shim, Aminat Ibikunle, Jeanne Cho, Frank R. Chung, Susan E. Cohen

Student Papers, Posters & Projects

Introduction: Palliative care is recommended for patients with life-limiting illnesses; however, there are few standardized protocols for outpatient palliative care visits. To address the paucity of data, this article aims to: (1) describe the elements of outpatient palliative care that are generalizable across clinical sites; (2) achieve consensus about standardized instruments used to assess domains within outpatient palliative care; and (3) develop a protocol and intervention checklist for palliative care clinicians to document outpatient visit elements that might not normally be recorded in the electronic heath record.

Methods: As part of a randomized control trial of nurse-led telephonic case management …

A Systematic Review Of The Efficacy Of Motivational Interviewing On Occupational Performance, J. Binder, Ots, C. Hannum, Ots, C. Mccarthy, Ots, E. Mcleod, Ots, J. Overpeck, Ots, L. Kaiser, Otd, Ms, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review aims to review the efficacy of MI to address such performance goals falling within the occupational therapy scope of practice.

Effect Of Motor Imagery On Children With Developmental Disabilities, J. Bonner, Ots, L. Finnegan, Ots, V. Leonard, Ots, M. Scuderi, Ots, A. Shacklett, Ots, J. Thiel, Ots, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review provides a comprehensive summary of current research evidence with the intent to help OTs working in pediatric settings understand the potential outcomes of using MI with children with DD.

A Systematic Review: Light Therapy For Individuals With Dementia And Implications For Practice, E. Goodman, Ots, A. Milione, Ots, C. Mikus, Ots, E. Jacobs, Ms, Ots, A. Torres, Ots, V. Vu, Ots, L. Kaiser, Otd, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review seeks to answer the question: is light therapy an effective intervention for sundowning symptoms experienced by individuals who have dementia?

Efficacy Of Alternative Seating On Attention, In-Seat Behavior, And Occupational Performance In Children With Attention Deficit Hyperactivity Disorder, A. Chacko, K. Kosztyo, N. Long, Z. Mullan, J. Norkitis, L. Wratcher, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

Currently, there is one systematic review conducted by Gochenour and Poskey7 that synthesize current research evidence regarding alternative seating for students with attention difficulties. A limitation of this review, as noted by the authors, is a lack of a consistent definition of attention difficulty in the studies they included. A systematic review focused on a specific, well-defined diagnosis will better contribute to practice recommendations since these recommendations will be tailored to a clear and comprehensive understanding of the child’s attentional and occupational challenges. The review also included studies of children with autism spectrum disorder (ASD).7 While those with ASD may …

The Effect Of Mirror Therapy On Upper Extremity Functioning For Patients Poststroke: A Systematic Review, Caitlin Beach, Halie Finke, Abby Garrity, Amanda Norcini, Lily Postus, Kristen Tekel, Lyn Kaiser, Otd, Otr/L

Student Papers, Posters & Projects

Due to the high incidence of stroke and the detrimental impact it can have on a patient’s independence, several systematic reviews examining the effect of MT on post-stroke rehabilitation for upper extremity functioning have been conducted. However, it is necessary to provide an update to existing systematic reviews to include new clinical studies that have recently been published. Since stroke is a leading cause of disability, this study aims to determine the effectiveness of MT in post-stroke rehabilitation for upper extremity function as compared to conventional therapy.

Health Insurance Coverage Of Recommended Gender-Affirming Health Care Services For Transgender Youth: Shopping Online For Coverage Information, Nadia L. Dowshen, Julie Christensen, Siobhan Gruschow

Student Papers, Posters & Projects

We assessed online health insurance plan indication of coverage and accessibility of information for recommended services for transgender youth (TY). Content analysis was performed for plans used at a pediatric Gender Clinic by reviewing information about coverage of puberty blockers, hormones, masculinizing chest surgery, and counseling. Transgender-specific exclusions and the time required for the research assistant to review each plan's online information were noted. No plan (0%; n=36) indicated coverage of all four categories of recommended services online. Forty-nine percent indicated ≥1 transgender-specific exclusion. The median time required for a research assistant to review online coverage information for each insurance …

Telemedicine Training In Undergraduate Medical Education: Mixed-Methods Review., Shayan Waseh, Mph, Adam P. Dicker, Md, Phd, Fastro

Student Papers, Posters & Projects

BACKGROUND: Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of …

Right Ventricular Outflow Tract Velocity Time Integral-To-Pulmonary Artery Systolic Pressure Ratio: A Non-Invasive Metric Of Pulmonary Arterial Compliance Differs Across The Spectrum Of Pulmonary Hypertension., Priyanka T. Bhattacharya, Gregory S. Troutman, Frances Mao, Arieh L. Fox, Monique S. Tanna, Payman Zamani, E. Wilson Grandin, Jonathan N. Menachem, Edo Y. Birati, Julio A. Chirinos, Sula Mazimba, Kerri Akaya Smith, Steven M. Kawut, Paul R. Forfia, Anjali Vaidya, Jeremy A. Mazurek

Student Papers, Posters & Projects

Pulmonary arterial compliance (PAC), invasively assessed by the ratio of stroke volume to pulmonary arterial (PA) pulse pressure, is a sensitive marker of right ventricular (RV)-PA coupling that differs across the spectrum of pulmonary hypertension (PH) and is predictive of outcomes. We assessed whether the echocardiographically derived ratio of RV outflow tract velocity time integral to PA systolic pressure (RVOT-VTI/PASP) (a) correlates with invasive PAC, (b) discriminates heart failure with preserved ejection-associated PH (HFpEF-PH) from pulmonary arterial hypertension (PAH), and (c) is associated with functional capacity. We performed a retrospective cohort study of patients with PAH (n = 70) and …

A Case Report Of Case Report Pursuit By Medical Student, Jonathan Li, Jennifer Wilson, Wayne Bond Lau

Student Papers, Posters & Projects

Medical students often seek case reports as vehicles for academic writing opportunities, conference presentation avenues, and residency/fellowship application highlights. Here we review a case where, due to unfortunate circumstances, a student made a unique diagnosis central to proper patient clinical care, wished to write up the case subsequently, but was ultimately excluded from the final work stemming from the patient case. We review the pitfalls that occurred in the process of pursuing publication of an interesting case, the educational value of pursuing case reports for students, the necessity for strong mentorship in this process, and general principles that medical students …

Utilizing The Boston Syncope Observation Management Pathway To Reduce Hospital Admission And Decrease Adverse Outcomes, Oren J. Mechanic, Celine Y. Pascheles, Gregory J. Lopez, Alina M. Winans, Nathan I. Shapiro, Carrie Tibbles, Richard E. Wolfe, Shamai A. Grossman

Student Papers, Posters & Projects

Introduction: In an age of increasing scrutiny of each hospital admission, emergency department (ED) observation has been identified as a low-cost alternative. Prior studies have shown admission rates for syncope in the United States to be as high as 70%. However, the safety and utility of substituting ED observation unit (EDOU) syncope management has not been well studied. The objective of this study was to evaluate the safety of EDOU for the management of patients presenting to the ED with syncope and its efficacy in reducing hospital admissions.

Methods: This was a prospective before-and-after cohort study of consecutive patients presenting …

Transcatheter Arterial Embolization Versus Surgery For Refractory Non-Variceal Upper Gastrointestinal Bleeding: A Meta-Analysis., Antonio Tarasconi, Gian Luca Baiocchi, Vittoria Pattonieri, Gennaro Perrone, Hariscine Keng Abongwa, Sarah Molfino, Nazario Portolani, Massimo Sartelli, Salomone Di Saverio, Arianna Heyer, Luca Ansaloni, Federico Coccolini, Fausto Catena

Student Papers, Posters & Projects

Background: Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or referred to transcatheter arterial embolization (TAE)?

Objectives: To carry out a systematic review of the literature and to perform a meta-analysis of studies that directly compare TAE and surgery in patients with refractory NVUGIB.

Materials and methods: We searched PubMed, Ovid MEDLINE, and Embase. A combination of the MeSH terms "gastrointestinal bleeding"; "gastrointestinal hemorrhage"; "embolization"; "embolization, therapeutic"; and "surgery" were used (("gastrointestinal bleeding" or "gastrointestinal hemorrhage") and ("embolization" or "embolization, therapeutic") …

A Systematic Review Of Level I Evidence In The Treatment Of Uterine Fibroids, Varun Singh, Geogy Vatakencherry, Md

Student Papers, Posters & Projects

Purpose

To systematically review randomized controlled trial data to compare the efficacy of uterine artery embolization (UAE), highintensity focused ultrasound (HIFU), hysterectomy, and medical therapy in the management of symptomatic uterine fibroids

Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld

Student Papers, Posters & Projects

Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.

Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of …

"In A Perfect World, You Wouldn't Have To Work The System To Get The Things You Need To Survive": A Pilot Study About Trans Health Care Possibilities., Ryan E. Pryor, William Vickroy

Student Papers, Posters & Projects

Purpose: aTHeNA (a Trans Health Needs Assessment) is a pilot study exploring the perspectives and experiences of trans people in western Massachusetts on and with health care. This study examines research strategies and best practices to improve trans health care by prioritizing the knowledge and recommendations of trans and gender nonbinary people.

Methods: aTHeNA is composed of a focus group of eight trans and gender nonbinary individuals held in western Massachusetts in January of 2016 and qualitative analysis of that focus group to synthesize themes. aTHeNA utilized an interdisciplinary approach. Concepts of respect, care, self-definition, and intersectionality informed study …