Medicine and Health Sciences Commons^™

Unconscious Bias In Medicine, Dorothy E. Roberts, Pcom Office Of Diversity And Community Relations

Diversity and Inclusion

2019 Dr. Martin Luther King, Jr. Lecture Series

Given by Dorothy E. Roberts, University of Pennsylvania School of Law, George A. Weiss University, Professor of Law

Depressive Symptoms In People With Vision Impairment: A Cross-Sectional Study To Identify Who Is Most At Risk, Claire Nollett, Barbara Ryan, Nathan Bray, Catey Bunce, Robin J. Casten, Rhiannon Tudor Edwards, David Gillespie, Daniel J. Smith, Miles Stanford, Tom H. Margrain

Department of Psychiatry and Human Behavior Faculty Papers

Objective To identify the risk factors for significant depressive symptoms in people with visual impairment in England and Wales to provide information on who is most at risk and to whom support services could be targeted in future. Design A cross-sectional study using baseline data from a pragmatic randomised controlled trial. Setting and participants 990 participants aged 18 or over attending 1 of 14 low-vision rehabilitation primary care optometry-based clinics in South Wales or two hospital clinics in London. Outcome measure A score of ≥6 on the Geriatric Depression Scale-15 was classed as clinically significant depressive symptoms. Results In a …

Friendly Schools Universal Bullying Prevention Intervention: Effectiveness With Secondary School Students, Donna Cross, Kevin C. Runions, Therese Shaw, Janice W. Y. Wong, Marilyn Campbell, Natasha Pearce, Sharyn Burns, Leanne Lester, Amy Barnes, Ken Resnicow

Research outputs 2014 to 2021

Peer bullying in schools is a significant public health problem that contributes to poor health and wellbeing outcomes for those who bully or are bullied. Meta-analyses of the efficacy of secondary school bullying prevention interventions have typically found no effects or an increase in student bullying. Consequently, few secondary school studies have examined the “real-world” effectiveness of these interventions. This age-cohort study design evaluated the effectiveness of the Friendly Schools (FS) secondary school intervention, previously found to be efficacious. FS was implemented in schools under real-world conditions by an education publisher. Student survey data were collected in 12 schools. The …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexandra A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanne C. Schuster, Justin B. Stoler, Amber Wutich, Jonathan Maupin, Monet Niesluchowski, Asiki Gershim, Divya Krishnakumar

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which waterrelated problems have been reported (eg, shortages, excess …

"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 …

Evaluation Of The Cost-Effectiveness Of The Treatment Of Uncomplicated Severe Acute Malnutrition By Lady Health Workers As Compared To An Outpatient Therapeutic Feeding Programme In Sindh Province, Pakistan, Eleanor Rogers, Saul Guerrero, Deepak Kumar, Sajid Bashir Soofi, Shahid Fazal, Karen Martínez, Jose Luis Alvarez Morán, Chloe Puett

Department of Paediatrics and Child Health

Background: Due to the limited evidence of the cost-effectiveness of Community Health Workers (CHW) delivering treatment for severe acute malnutrition (SAM), there is a need to better understand the costs incurred by both implementing institutions and beneficiary households. This study assessed the costs and cost-effectiveness of treatment for cases of SAM without complications delivered by government-employed Lady Health Workers (LHWs) and complemented with non-governmental organisation (NGO) delivered outpatient facility-based care compared with NGO delivered outpatient facility-based care only alongside a two-arm randomised controlled trial conducted in Sindh Province, Pakistan.
Methods: An activity-based cost model was used, employing a societal perspective …

Maintaining Stability In A Changing Climate: A Comparative Analysis Of Public Health Systems And Migration Policies In The U.S. And Canada, Laura Cutlip

Climate and Society

This paper examines the relation between climate change, migration, and public health to better understand how the United States health system is positioned to deal with likely challenges to human health posed by environmental changes. The author reviews probable impacts of climate change on population displacement and disease before considering how the current structure of the health system of the United States will render it unable to adapt to these changes and challenges. The Canadian health care system and refugee policies are then reviewed to provide a counterpoint to this analysis. These findings are then considered in tandem as the …

Demethylation By Low-Dose 5-Aza-2'-Deoxycytidine Impairs 3d Melanoma Invasion Partially Through Mir-199a-3p Expression Revealing The Role Of This Mir In Melanoma., Cécile Desjobert, Arnaud Carrier, Audrey Delmas, Diego M Marzese, Antoine Daunay, Florence Busato, Arnaud Pillon, Jörg Tost, Joëlle Riond, Gilles Favre, Chantal Etievant, Paola B Arimondo

Articles, Abstracts, and Reports

BACKGROUND: Efficient treatments against metastatic melanoma dissemination are still lacking. Here, we report that low-cytotoxic concentrations of 5-aza-2'-deoxycytidine, a DNA demethylating agent, prevent in vitro 3D invasiveness of metastatic melanoma cells and reduce lung metastasis formation in vivo.

RESULTS: We unravelled that this beneficial effect is in part due to MIR-199A2 re-expression by promoter demethylation. Alone, this miR showed an anti-invasive and anti-metastatic effect. Throughout integration of micro-RNA target prediction databases with transcriptomic analysis after 5-aza-2'-deoxycytidine treatments, we found that miR-199a-3p downregulates set of genes significantly involved in invasion/migration processes. In addition, analysis of data from melanoma patients showed a …

The Carotid Sinus Nerve And The First English Translation Of Hering's Original Research On This Nerve., Mohammadali M Shoja, Rabjot Rai, Stefan Lachkar, Seleipiri Iboroma Akobo, Emre Yilmaz, Marios Loukas, Emanuela Binello, Mehrnoush Gorjaian, Christoph J Griessenauer, Joe Iwanaga, R Shane Tubbs

Articles, Abstracts, and Reports

This paper provides a brief depiction of the life and achievements of the most iconic experiments of Heinrich Ewald Hering. The authors herein have presented a translation of his paper on the carotid sinus nerve in English; the original paper by Heinrich Ewald Hering, titled "Ueber die Wand des Sinus caroticus als Reizempfänger und den Sinusnerv als zentripetale Bahn für die Sinusreflexe" (1924), provides a detailed account of his experimental process and findings. He recognized that the sinus reflexes are mediated by a branch of the glossopharyngeal nerve (CN IX).

Optimization Of Faculty Practice Revenue: Lessons Learned From The Past Four Years, Kelly Gonzales, Amelia P. Stoltman, Kate Fiandt

Posters and Presentations: College of Nursing

No abstract provided.

Creating And Administering A Faculty Practice Fund, Kelly Gonzales, Amelia P. Stoltman

Posters and Presentations: College of Nursing

No abstract provided.

Optimization Of Faculty Practice Revenue: Lessons Learned From The Past Four Years, Kelly Gonzales, Amelia Stoltman

Posters and Presentations: College of Nursing

No abstract provided.

Model-Based Virtual Patient Analysis Of Human Liver Regeneration Predicts Critical Perioperative Factors Controlling The Dynamic Mode Of Response To Resection., Babita Verma, Pushpavanam Subramaniam, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Liver has the unique ability to regenerate following injury, with a wide range of variability of the regenerative response across individuals. Existing computational models of the liver regeneration are largely tuned based on rodent data and hence it is not clear how well these models capture the dynamics of human liver regeneration. Recent availability of human liver volumetry time series data has enabled new opportunities to tune the computational models for human-relevant time scales, and to predict factors that can significantly alter the dynamics of liver regeneration following a resection.

METHODS: We utilized a mathematical model that integrates signaling …

Discovering The Immune Cell Landscape In Ipf By Whole Lung Single Cell Transcriptomics, Jonas C. Schupp, Taylor Adams

Yale Day of Data

Single cell transcriptomes of 27 IPF, 13 COPD and 14 control lungs were established. Cells were clustered into major cell types, then the immune cells consisting of 116,057 myeloid, 4,742 B-, and 19,165 T-& NK-cells were analyzed and subclustered. Subclustering revealed IPF-associated unique gene expression profiles subpopulations that were specific to the IPF lung. For example, we could identify an IPF-specific macrophage subpopulation which showed a pro-fibrotic profile characterized by SPP1, CHIT1, CCL18, SPARC, LGMN, CTSK, and MMP9 gene expression. Antagonistically, NK- and cytotoxic T-cells revealed a significantly increased expression of the protease inhibitors A2M and PZP in the IPF …

The Road To Resilience: Traveling The Path Less Followed To Realize What Is Possible, Jennifer Fortuna

The Open Journal of Occupational Therapy

Dr. Bernadette Mineo, PhD, OTR/L, an occupational therapist and mixed media artist based in Portland, Oregon, provided the cover art for the Winter 2019 issue of The Open Journal of Occupational Therapy (OJOT). The piece, titled “Paper Dolls” (2009), consists of 37 individual paper doll sculptures made from mixed media. Dr. Mineo believes that being an artist is about connecting with one’s creative heart. Her art is about being playful, challenging oneself, and setting up experiments. Engaging in a daily creative art practice has brought joy to Dr. Mineo’s life. Art has empowered her to take risks, build resilience, and …

Increasing Functional Abilities Of People With Postural Orthostatic Tachycardia Syndrome Through Occupational Therapy, Jennifer R. Dochod, Cynthia A. Grapczynski

The Open Journal of Occupational Therapy

The level of functional impairment that people with Postural Orthostatic Tachycardia Syndrome (POTS) experience is life changing. Reduced engagement in purposeful and meaning activities because of functional impairments increases the emotional impact of POTS and decreases quality of life. By including occupational therapy early on in treatment, people with POTS can learn ways to adapt, cope, and incorporate changes into their lifestyles. Increasing participation in purposeful and meaningful occupations that are of value to the individual leads to increased quality of life, increased participation in desired roles, increased sense of well-being, and increased perception of health.

The Role Of Occupational Therapy In Functional Literacy, Lenin C. Grajo, Sharon A. Gutman

The Open Journal of Occupational Therapy

In this Opinions in the Profession article we aim to uniquely articulate the distinct value of and need for functional literacy development in the clients we serve. Functional literacy, as coined in this article, is the ability to interpret common written materials needed to effectively carry out basic daily life skills and participate in meaningful occupations and social roles. We propose three specific strategies through which occupational therapists, across practice settings, developmental stages, and populations, can assume active roles in literacy support as it is embedded in occupation: literacy (a) as a form of occupational justice promotion; (b) as an …

Role Emerging Placements: Skills Development, Postgraduate Employment, And Career Pathways, Sobiya Syed, Andrea Duncan

The Open Journal of Occupational Therapy

Occupational therapy educators are increasingly using role emerging placements (REPs) as a forum for students to develop skills required to work in emerging areas of practice. This study explores the impact of REPs on skill development, postgraduate employment, and career pathways for occupational therapists. An online survey was sent to occupational therapists across Canada (n = 1,763). Occupational therapists who had completed a REP responded to the online survey (n = 88). Descriptive analysis was used to examine trends in the quantitative data, and content analysis was used to code categories derived from qualitative survey data. Results indicated five skills …

Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello

The Open Journal of Occupational Therapy

The use of simulation as a teaching and learning stratagem is well supported in the professional literature. The development of a collaborative care best practices model (CCBPM) was undertaken to help the creation and implementation of an interprofessional education (IPE) learning strategy between occupational therapy assistant (OTA) and pre-licensure nursing students at a private liberal arts college. The project goals and outcomes involved faculty development, CCBPM development, and OTA and nursing novice student competency acquisition in their respective professions. Twenty-three students (10 OTA and 13 nursing) completed the IPE learning simulation exercise. A mixed-method approach to data analysis was used …

Enhancing Collaborative Practices With Preprofessional Occupational Therapists And Early Childhood Special Education Student Teachers: A Pilot Study, Kathleen M. Farrand, Megan Troxel Deeg, Oaklee Rogers, Allison M. Mullady, Stephanie S. Williams, Bjorg T. Lesueur

The Open Journal of Occupational Therapy

This article presents the Collaborative Design Model as a tool for developing collaboration and self-efficacy for preprofessional educators and service providers. As student populations continue to become more diverse, preprofessionals entering the classroom must be prepared to collaborate with colleagues effectively and efficiently to address the variety of needs presented in the classroom. Little research exists on the collaboration among preprofessional teachers and preprofessional occupational therapists. The proposed model provides a method for supporting preprofessionals in collaborating to meet the needs of students at risk for or with disabilities. Initial pilot findings suggest the Collaborative Design Model could potentially increase …

Occupational Therapist Licensure Revocation By State Licensing Boards, Regina Drummond, Myrel Agbayani, Christine Chong, Chris Josko, Shelby Murley, Brenda M. Coppard

The Open Journal of Occupational Therapy

Occupational therapists must abide by certain standards to maintain a license to practice. Despite the existence of various studies on licensure revocation in other health care professions, no prior research has been conducted regarding occupational therapist licensure revocations. The purpose of this study was to examine reasons for occupational therapy licensure revocations in the United States from 2005 to 2015. A retrospective descriptive study design was completed. Data were collected from public databases on state websites or through communication with state licensure board representatives. From 2005 to 2015, 65 occupational therapists had their licenses revoked in 40 states and the …

A Scoping Review Of Challenges And The Adaptation Process In Academia: Implications For Occupational Therapy Educators, Maria Concepcion C. Cabatan, Lenin C. Grajo, Erlyn A. Sana

The Open Journal of Occupational Therapy

The fulfillment of role expectations and responsibilities as one builds an academic career can be challenging. Increased demand for occupational therapy faculty merits examination of academic experiences from the literature. This study describes the experiences of educators using adaptation models (Savickas & Porfeli, 2012; Schkade & Schultz, 2003) as a theoretical lens. Arksey and O’Malley’s Scoping Study Framework (2005) was used in the study. Researchers reviewed literature from 2005-2017 from four databases. Researchers analyzed 28 articles from higher education and the health professions using quantitative and qualitative methods. Twenty-two of the 28 articles were published from 2010-2017. The studies analyzed …

The Effects Of The Leisure Activity Of Coloring On Post-Test Anxiety In Graduate Level Occupational Therapy Students, Brittney N. Burton, Mary F. Baxter

The Open Journal of Occupational Therapy

Background: This study examined the effects of the leisure activity of coloring on the anxiety levels of graduate level occupational therapy students after taking a high stress exam. This study also examined the effects of the leisure activity of coloring on the students’ perceptions of preparedness for and performance on the exam.

Method: The participants were recruited for this quantitative, pre/posttest study through a purposive convenience sample and randomly assigned to either the leisure activity or the control. A self-report assessment was used for data collection. The changes in anxiety levels were examined using a repeated measures analysis …

The Feasibility Of Conducting Task-Oriented Training At Home For Patients With Stroke, Veronica T. Rowe, Marsha Neville

The Open Journal of Occupational Therapy

Background: Task-oriented training for upper extremity hemiparesis following a stroke is an effective intervention with evidence of its application in the clinic setting. However, the home provides an enriched and practical environment to implement this intervention. This report presents the feasibility of implementing task-oriented training at home.

Method: Stroke survivors with limitations in upper extremity movement and function were assessed before and after a Task-Oriented Training and Evaluation at Home (TOTE Home) program, and 1 month later. Areas of process, resources, management, and scientific value were analyzed for the feasibility of a larger randomized clinical trial (RCT).

Results …

Older Adults And Photo-Elicited Perspectives On Shopping For Groceries In A Changing Community, Lori E. Breeden, Alessandra Planera, Lauren Kirchner, Samantha Asencio, Matthew Branden, Evan Dunlap, Alex Robinson, Samantha Stevens, Sally Wasmuth

The Open Journal of Occupational Therapy

Background: A community experiencing gentrification created challenges for older adults and their ability to access food. The purpose of this qualitative study was to examine barriers and facilitators perceived by three urban-dwelling older adults during their grocery shopping experiences.

Methods: The researchers conducted photo-elicitation supported interviews to gather information on grocery shopping from three older adults attending a local senior center. Photo-elicited interviews were conducted, and the thematic analysis examined the participants’ perspectives on their experiences.

Results: Thematic analysis revealed the participants’ experiences in a changing landscape. In the categories of community resources, transportation, and the store, …

The Sensory Processing 3-Dimensions Scale: Initial Studies Of Reliability And Item Analyses, Shelley Mulligan, Sarah A. Schoen, Lucy Jane Miller, Andrea Valdez, Deborah Magalhaes

The Open Journal of Occupational Therapy

Background: The Sensory Processing 3-Dimensions Scale (SP-3D) is a performance-based measure for assessing sensory processing abilities and challenges, including sensory modulation, sensory discrimination, and sensory-based motor disorders. Initial studies of reliability were conducted, and item response theory was applied to assist in refining the measure.

Methods: Descriptive and correlational methods were used to examine internal consistency of the scales and inter-rater reliability. Item response theory using Rasch analyses was applied to examine unidimensionality of scales, model fit, and item difficulty.

Results: Internal consistency for most measures was acceptable, demonstrating the subtests, domains, and behavior scales as distinct …

Effects Of Partnerships Between Adolescents With Developmental Disabilities And Service Dogs, Terry K. Crowe, Jean C. Deitz, Melissa Y. Winkle, Rachel A. Nelson, Jennifer Woolf

The Open Journal of Occupational Therapy

Background: With increasing frequency, service dogs are being placed with children with developmental disabilities (DDs). Occupational therapists and other professionals have advocated for the therapeutic use of service dog partnerships to facilitate greater independence and quality of life. There are no studies that examine service dog intervention with adolescents.

Method: This study focused on the effects of partnerships between service dogs and three participant dyads, each including an adolescent with DDs and a parent. A single-subject, alternating treatment design was used to compare the effects of two conditions (service dog present or not present). The effects were examined …

The Lived Experiences Of Occupational Therapists In Transitioning To Leadership Roles, Shawn Sasha Shams, Ravneet Batth, Andrea Duncan

The Open Journal of Occupational Therapy

Background: Several studies on leadership in occupational therapy have discussed the key qualities of leadership and its importance, even though little is known about the transition process into leadership roles. This research examined the lived experiences of occupational therapists who have transitioned from a clinical to a leadership role and identified the supports and challenges that were found to be important.

Methods: Semi-structured interviews were used to gain insight into the transition process of five occupational therapy professional practice leaders. NVivo software was used to organize and analyze the qualitative data.

Results: Three common themes were identified as “supports” for …

State Of The Journal: Moving Forward, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Sustainability Of Public Health Interventions: Where Are The Gaps?, David Roger Walugembe, Shannon Sibbald, Marlene Janzen Le Ber, Anita Kothari

Health Studies Publications

The current scholarly focus on implementation science is meant to ensure that public health interventions are effectively embedded in their settings. Part of this conversation includes understanding how to support the sustainability of beneficial interventions so that limited resources are maximised, long-term public health outcomes are realised, community support is not lost, and ethical research standards are maintained. However, the concept of sustainability is confusing because of variations in terminology and a lack of agreed upon measurement frameworks, as well as methodological challenges. This commentary explores the challenges around the sustainability of public health interventions, with particular attention to definitions …