Medicine and Health Sciences Commons^™

Cost Savings And Patient Satisfaction Following Implementation Of An Online Blockchain-Based Healthcare Payment Portal, Zubin Hussain, Meghan Gannon, Phd, Constantine Daskalakis, Scd

Phase 1

Introduction. Although most patients prefer e-billing, many providers use paper. On average, over three paper bills are sent before payment is received. This means wasted time, money, energy, and decreased patient satisfaction. Could the implementation of an online, blockchain-based healthcare payment portal increase cost savings and patient satisfaction while maintaining confidentiality?

Methods. Transaction data was collected by MAPay through their portal system from about 100 providers in 50 locations in the NYC area, all through IntegraConnect. This study analyzes trends in how patients pay their medical bills and how much they pay.

Results. From March through September, all electronic methods …

We Was Somebody, Kyle Rodgers, Abigail Kay, Md

Phase 1

As the number of people who inject drugs (PWID) in Philadelphia increases, more healthcare professionals find themselves treating patients suffering from IV drug addictions. Unfortunately, many of these busy healthcare professionals have little education on the biochemistry of addiction and obstacles between people who inject drugs (PWID) and their recovery. We Was Somebody, a fictional play inspired by the stories of PWID in Kensington, Philadelphia, aims to promote understanding and empathy for the complexity of addiction and ultimately improve the quality of healthcare provided to the human beings affected by it.

The content of the play comes from peer-reviewed …

Along A River In The Wilds: A Podcast, Rhianna Hibbler, Howard Rabinowitz, Bob Motley

Phase 1

Introduction: The American urban-rural divide has been further magnified by discourse surrounding the 2016 election. Through this project we aimed to uncover stories of people from three small towns in rural north central Pennsylvania who are identifying and overcoming challenges by harnessing their region’s strengths in order to improve local social, economic, educational, and health outcomes.

Methods: Interviews were recorded with 10 local change-makers. Core topics included Community Initiatives, Education, and Healthcare, within the communities of Lock Haven, Jersey Shore, and Renovo. Edited podcast episodes are released under “Along a River in the Wilds,” available on major platforms including Apple …

Internal Medicine Consultation For Dentists, Nina Mingioni, Md

Clinical Education Teaching Tools

Learning Objectives:

• Recognize ubiquitous nature of common medical condition in general population
• Discuss implications of common medical conditions on dental care of patients
• Identify concerns affecting patients that would necessitate medical consultation prior to dental intervention

Jefferson Digital Commons Quarterly Report: October-December 2019, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• Articles
• Dean's Research Development Lunch Conference
• Dissertations
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• Journals and Newsletters
• Population Health Presentation Materials
• Posters
• Reports
• Symposiums
• What People are Saying About the Jefferson Digital Commons

Case Report: Co-Existence Of Brca2 And Palb2 Germline Mutations In Familial Prostate Cancer With Solitary Lung Metastasis., Tang Tang, Lin-Ang Wang, Peng Wang, Dali Tong, Gaolei Liu, Jun Zhang, Nan Dai, Yao Zhang, Gang Yuan, Kyla Geary, Dianzheng Zhang, Qiuli Liu, Jun Jiang

PCOM Scholarly Works

Background: Mutation-caused loss-of-function of factors involved in DNA damage response (DDR) is responsible for the development and progression of ~20% of prostate cancer (PCa). Some mutations can be used in cancer risk assessment and informed treatment decisions.

Methods: Target capture-based deep sequencing of 11 genes was conducted with total DNA purified from the proband's peripheral blood. Sanger sequencing was conducted to screen potential germline mutations in the proband's family members. Targeted sequencing of a panel of 1,021 genes was done with DNA purified from the tumor tissue.

Results: Two previously unreported germline mutations in the DDR pathway,

Conclusions: The newly …

Reproductive Justice Disrupted: Mass Incarceration As A Driver Of Reproductive Oppression, Crystal M. Hayes, Carolyn B. Sufrin, Jamila B. Perritt

School of Social Work Faculty Publications

We describe how mass incarceration directly undermines the core values of reproductive justice and how this affects incarcerated and nonincarcerated women.

Mass incarceration, by its very nature, compromises and undermines bodily autonomy and the capacity for incarcerated people to make decisions about their reproductive well being and bodies; this is done through institutionalized racism and is disproportionately done to the bodies of women of color. This violates the most basic tenets of reproductive justice—the right to have a child, not to have a child, and to parent the children you have with dignity and in safety.

By undermining motherhood and …

Mast Cells As Novel Effector Cells In The Pathogenesis Of Chronic Graft-Versus-Host Disease, Ethan Strattan

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Hematopoietic stem cell transplantation (HSCT) is most commonly a treatment for inborn defects of hematopoiesis or acute leukemias. Widespread use of HSCT, a potentially curative therapy, is hampered by onset of graft-versus-host-disease (GVHD), a condition wherein the donor cells recognize the patient tissues as non-self. GVHD can manifest anywhere from weeks to decades post-transplant and is classified as either acute or chronic GVHD, both of which are significant causes of transplant-related morbidity and mortality.

However, GVHD is a complex, multifactorial, and enigmatic disease. The factors driving GVHD at the cellular and molecular level are incompletely understood. Immunosuppression targeting T-cells has …

Medical Utilization In The Context Of Culture: Analyzing The Concepts, Benefits And Drawbacks Of Sri Lankan Biomedical And Ayurvedic Healthcare, Miriah Rajaguru

All Graduate Theses, Dissertations, and Other Capstone Projects

Sri Lanka is an island inhabited by a culture more than 5,000 years old. The primary medicine utilized by this culture in precolonial times is known as Ayurveda. During colonization, Sri Lanka was introduced to biomedicine and forced to negate Ayurvedic medicine. Throughout the years, rather than abandoning their indigenous medical practice, Sri Lanka incorporated biomedicine and Ayurvedic medicine into their medically plural society. Today, Sri Lankans utilized both medicines for different ailments, concerns and conditions. Utilizing a variety of anthropological methods and theories, this study gathered qualitative information from 39 Sri Lankan informants. These informants were recruited to find …

Fieldwork Educator Preparedness: A Study Examining The Effect Of An Online Learning Module On The Perceived Preparedness Levels Of Fieldwork Educators, Breanna Chycinski

Occupational Therapy Doctorate Capstone Projects

The purpose of this research project was to compare how the implementation of a learning module, titled The Fieldwork Educator Competency Module altered the perceived level of preparedness of occupational therapy (OT) practitioners related to their role as a fieldwork educator (FWEd) for Level II OT students. A quantitative, pre-experimental, one group pretest-posttest research design was used. All components of the research took place in an online, virtual setting. Participants were OT practitioners who were eligible to be a Level II FWEd. Results indicate a positive change for at least one participant for each question of the survey. The largest …

The Impact Of Mobile Media On The Fine Motor Development Of Students Entering Into The Educational System, Bernadette H. Needham

Occupational Therapy Doctorate Capstone Projects

The prevalence of mobile technology has greatly increased in our society over the last ten years. As COVID-19 continues to impact our society, the long-term impact of mobile media continues to be a concern with the movement to remote learning. The purpose of this research is to examine the parent’s perspective of increased mobile media usage at a young age on the development of fine motor skills needed for participation in kindergarten. The literature that was reviewed indicates that currently no definitive understanding of the impact of increased mobile media is known. The research was guided through decision making based …

Occupational Therapy Support In The Kindergarten Classroom Through Rti Tier I Interventions: Kindergarten Teachers’ Perceptions Of Need, Robyn R. Scarlett

Occupational Therapy Doctorate Capstone Projects

Known for the protection it affords children with disabilities, the federal statute, Individuals with Disabilities Education Act (IDEA), 2004, also provides Local Education Agencies (LEA) funding to support general education students that may be at risk of or are demonstrating difficulty within their educational programming. Response to Intervention (RtI) is one such framework commonly used in school districts around the country to provide multi-tiered support to at-need general education students to facilitate their successful participation in their academic programming. The purpose of this study was to learn what occupational-therapy performance skills kindergarten teachers saw as areas of concern in children …

The Impact Of Parent Education With Augmentative And Alternative Communication, Kirsta Von Hellens

Occupational Therapy Doctorate Capstone Projects

Communication is an essential part of who we are, as we participate in our occupational roles, even for those who utilize augmentative and alternative communication. The purpose of this project was to evaluate the impact of a parental training program, as parents utilized a communication device, in order to increase the number of opportunities for their child to engage with and participate with at home and in the community. This project utilized the Human Activity Assistive Technology and the Person, Environment, Occupation, and Performance model. A descriptive mixed methods case study with a sequential exploratory design was used in this …

Occupational Engagement In Adults Under Age 65 Living In Skilled Nursing Facilities (Oea-Snf), Rebecca A. King

Occupational Therapy Doctorate Capstone Projects

Background: Adults under age 65 living in skilled nursing facilities is a growing population and lack of occupational engagement in skilled nursing facilities is well documented. There is also a documented lack of training programs for skilled nursing facility staff to appropriately care for this population’s occupational needs. Occupational Therapists are uniquely qualified to educate and train skilled nursing facility staff in the occupational engagement needs of this group. Purpose: There is a lack of documented research regarding adults under age 65 living in skilled nursing facility and training programs for staff that care for this group. To …

Determining The Effect Of Target Education On Students’ Cultural Responsiveness And Performance During Standard Patient Interactions, Rebecca Mojica

Occupational Therapy Doctorate Capstone Projects

There is limited available data about the level of cultural responsiveness skills in occupational therapy students. The purpose of this capstone project was to ascertain the impact of target specific training in cultural diversity on students’ perception of cultural responsiveness, and on their performance during simulated patient interactions. The overreaching framework for this capstone project was the conceptual model for culturally responsive care. This capstone project followed a one group pretest and post-test quasi-experimental design. Participants consisted of second-year students enrolled in an entry level master occupational therapy program at a large urban public university. The pre and post-test self-assessment …

The Impact Of Cooking Groups On One Individual's Transition To Independent Living, Alison Garcia

Occupational Therapy Doctorate Capstone Projects

The goal of occupational therapy in inpatient psychiatric settings is to develop independent living skills and restore normative life roles vital for leading a fulfilling life in the least restrictive environment. In one psychiatric hospital, cooking groups are an essential intervention and environment in which to develop these skills and roles. The purpose of this qualitative case study is to describe OT cooking group programing in one inpatient psychiatric setting, understand one client’s experience with cooking groups and illustrate how her participation in these groups led to a successful transition to independent living. This study was guided by the transformative …

Off-Policy Q-Learning For Anti-Interference Control Of Multi-Player Systems, Jinna Li, Zhenfei Xiao, Tianyou Chai, Frank L. Lewis, Sarangapani Jagannathan

Electrical and Computer Engineering Faculty Research & Creative Works

This paper develops a novel off-policy game Q-learning algorithm to solve the anti-interference control problem for discrete-time linear multi-player systems using only data without requiring system matrices to be known. The primary contribution of this paper lies in that the Q-learning strategy employed in the proposed algorithm is implemented in an off-policy policy iteration approach other than on-policy learning due to the well-known advantages of off-policy Q-learning over on-policy Q-learning. All of the players work hard together for the goal of minimizing their common performance index meanwhile defeating the disturbance that tries to maximize the specific performance index, and finally …

Physical Therapy For Gait, Balance, And Cognition In Individuals With Cognitive Impairment: A Retrospective Analysis, Jason Longhurst, Jason Phan, Elbert Chen, Steven Jackson, Merrill R. Landers

Integrated Health Sciences Faculty Research

© 2020 Jason Longhurst et al. Objectives. The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods. Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The …

Optimisation Of The Performance Of Holographic Beam-Shaping Diffractive Diffusers Through Refinement Of The Recording Process, Cara Jones, Suzanne Martin, Sanjay Keshri, Dervil Cody, Kevin Murphy

Conference Papers

Optical diffusers have uses in laser applications and machine vision. Typical fabrication at a commercial level requires master production and the stamping/copying of individual elements at scale. This expensive, indirect process inhibits custom diffusers at reasonable cost. Previously the authors published a novel, direct, single beam method of recording customizable and controllable volume holographic diffusers by manipulating laser speckle and recording the pattern in photopolymer. This method allows for beam-shaping to produce diffusion patterns of various sizes and shapes. In this work, the direct method of recording controllable holographic diffusers is refined to improve diffuser performance (i.e., a decrease in …

Constitutionalizing Nature's Law: Dignity And The Regulation Of Biotechnology In Switzerland, James Toomey

Elisabeth Haub School of Law Faculty Publications

The Swiss Constitution was amended by referendum in 1992 to include two unique provisions: Article 119, which imposes strict limits on genetic and reproductive technologies in humans in order to protect ‘human dignity’, and Article 120, which commits the Swiss federal government to limiting genetic technologies in non-human species on the basis of the ‘dignity of the creature’. This article analyzes the role of ‘dignity’ as a limit on biotechnologies in the Swiss constitutional order. It concludes that the understanding of dignity the constitution embraces codifies a contestable metaphysical theory of value at the constitutional level. Specifically, the Swiss constitutional …

Reflections On Psychological And Psychiatric Consequences Of Covid-19 Pandemic, Donatella Marazziti

Animal Sentience

Although far from reaching a clear conclusion, some evidence increasingly highlights the possible connections among climate change, environmental pollution and the current COVID-19 pandemic, as well as their intertwined detrimental effects on both physical and mental health. Such a catastrophic event calls for a novel awareness of the interdependence of all biotic and nonbiotic factors in our environment and planet.

The Effects Of The Myokinesthetic System On Medial Tibial Stress Syndrome In The Physically Active: A Case Study, Rodrigo E. Martinez, Evelyn Benitez-Lopez, Lindsey Larkins

Clinical Practice in Athletic Training

Medial tibial stress syndrome (MTSS) is a common pathology in physically active people and one of many overuse leg injuries present in weight bearing athletes, with the highest prevalence in runners. Researchers have extensively explored treatment for MTSS, but a long-lasting and effective treatment option has not been established. This case report aimed to explore the effects of The MyoKinesthetic SystemTM (MYK), a form of manual therapy, on two athletes diagnosed with MTSS. Patient one is a 19-year-old male rugby player with a previous history of MTSS, who reported leg pain while running which progressed to constant pain. Patient two …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

The Effects Of A Plant-Based Diet On Inflammation Of Patients With Cardiac Disease, Rachel L. Butcher

Honors Undergraduate Theses

Cardiac disease is the primary cause of death in the United States of America (CDC, 2017). Despite ongoing efforts and investments to improve cardiac health in the United States, most of the population will suffer from cardiovascular diseases. There is a multitude of research supporting that diet can contribute to cardiac disease, but it is less known that diet can greatly contribute to regulation and reversal of cardiovascular disease processes (Huang et al., 2012; Satija et al., 2017; Kim et al., 2019). Existing research supports the efficacy of plant-based diets to manage and reverse certain cardiac diseases (Tuso et al., …

Hospital Footwear As A Vector For Organism Transmission, David J. Frederick

Honors Undergraduate Theses

In the United States healthcare system, nearly one in 31 patients contract a nosocomial infection. Footwear worn in these hospital settings are a factor that should be considered when determining contributing agents and methods for organism transmission. The purpose of this review is to synthesize the current research on hospital footwear as a vector for organism transmission. Eight studies were included in this review to examine the impact of wearable interventions on footwear-related contamination in the hospital setting and organism transfer as it relates to footwear and hospital environments. The link between the organism load and diversity on hospital worn …

Millennial Attitudes Toward Telehealth: An Integrative Literature Review, Hannah Gwyneth Y. Tabora

Honors Undergraduate Theses

Purpose: The primary purpose of this research was to explore individuals born in the millennial generation’s likelihood of using telehealth and virtual office visits as a replacement for face to face provider interactions. The secondary purpose was to examine the feasibility and access of treatable conditions and ailments in a virtual environment.

Methods: A literature review exploring millennials and telehealth was performed using various databases with search terms combined to include: ‘millennials*’, ‘telehealth*’, ‘telemed*’, ‘finance*’, ‘primary care*’, ‘healthcare*’, ‘health knowledge*’, ‘literacy*’, ‘education*’, ‘misinformation*’. The data was conformed into tables that synthesized the relationship between the millennial generation and their access …

Trophic Enteral Feeds In Mechanically Ventilated Adult Patients With Acute Respiratory Distress Syndrome/Acute Lung Injury And Associated Clinical Outcomes, Kiersten Ann Tidwell

Honors Undergraduate Theses

Enteral nutrition (EN) is often delayed in critically ill patients despite strong evidence to support that early enteral nutrition feeding is beneficial in this population. Adverse outcomes in critically ill patients in which nutrition is delayed include a longer length of stay and time on the ventilator, and a higher incidence of pneumonia and hospital mortality. The purpose of this literature review was to evaluate the current evidence regarding trophic enteral feeds in mechanically ventilated adult patients with acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and associated clinical outcomes. A retrospective literature review was performed to identify articles published …

Deployment And Travel Medicine Knowledge, Attitudes, Practices, And Outcomes Study (Kapos): Malaria Chemoprophylaxis Prescription Patterns In The Military Health System, Patrick W. Hickey, Indrani Mitra, Jamie Fraser, David Brett-Major, Mark S. Riddle, David R. Tribble

Journal Articles: Epidemiology

The Deployment and Travel Medicine Knowledge, Attitudes, Practices, and Outcomes Study (KAPOS) examines the integrated relationship between provider and patient inputs and health outcomes associated with travel and deployments. This study describes malaria chemoprophylaxis prescribing patterns by medical providers within the U.S. Department of Defense's Military Health System and its network of civilian healthcare providers during a 5-year period. Chemoprophylaxis varied by practice setting, beneficiary status, and providers' travel medicine expertise. Whereas both civilian and military facilities prescribe an increasing proportion of atovaquone-proguanil, doxycycline remains the most prevalent antimalarial at military facility based practices. Civilian providers dispense higher rates of …

Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen

Walden Dissertations and Doctoral Studies

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development. A …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …