Medicine and Health Sciences Commons^™

Technology-Enabled Behavioral Health Integration Decreases Emergency Department Utilization, Adam Pardes, Rachelle Rene, Phansy Chun Chun, Mollie Cherson

Jefferson Hospital Staff Papers and Presentations

Background:

Behavioral health integration allows for patient-centered care, leads to higher levels of provider-patient engagement, and is key to improving patient outcomes. However, behavioral health integration is administratively burdensome and therefore is often not adopted. Technology presents opportunities to increase care team efficiency and improve patient outcomes. The goal of this study was to retrospectively compare clinical outcomes and emergency department utilization in patients using a technology platform compared to patients receiving treatment as usual.

Methods:

The technology platform, NeuroFlow, was deployed to deliver technology-enabled behavioral health integration in 30 clinics, and 598 electronic health records were analyzed.

Results:

In …

Comorbidity Of Novel Crhr2 Gene Variants In Type 2 Diabetes And Depression, Mutaz Amin, Jurg Ott, Derek Gordon, Rongling Wu, Teodor T Postolache, Michael Vergare, Claudia Gragnoli

Department of Psychiatry and Human Behavior Faculty Papers

The corticotropin-releasing hormone receptor 2 (CRHR2) gene encodes CRHR2, contributing to the hypothalamic-pituitary-adrenal stress response and to hyperglycemia and insulin resistance. CRHR2-/- mice are hypersensitive to stress, and the CRHR2 locus has been linked to type 2 diabetes and depression. While CRHR2 variants confer risk for mood disorders, MDD, and type 2 diabetes, they have not been investigated in familial T2D and MDD. In 212 Italian families with type 2 diabetes and depression, we tested 17 CRHR2 single nucleotide polymorphisms (SNPs), using two-point parametric-linkage and linkage-disequilibrium (i.e., association) analysis (models: dominant-complete-penetrance-D1, dominant-incomplete-penetrance-D2, recessive-complete-penetrance-R1, recessive-incomplete-penetrance-R2). We detected novel linkage/linkage-disequilibrium/association …

Hospital Nursing Factors Associated With Decreased Odds Of Mortality In Older Adult Medicare Surgical Patients With Depression, Aparna Kumar, Douglas Sloane, Linda Aiken, Matthew Mchugh

College of Nursing Faculty Papers & Presentations

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship.

Methods: This was a retrospective cohort study employing a national nurse survey, hospital data, and Medicare claims data from 2006-2007. The sample included: 296,561 older adult patients, aged 65-90, who had general, orthopedic, or vascular surgery in acute care general hospitals …

Implication Of Melanocortin Receptor Genes In The Familial Comorbidity Of Type 2 Diabetes And Depression., Mutaz Amin, Jurg Ott, Rongling Wu, Teodor T Postolache, Claudia Gragnoli

Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers

The melanocortin receptors are G-protein-coupled receptors, which are essential components of the hypothalamic–pituitary–adrenal axis, and they mediate the actions of melanocortins (melanocyte-stimulating hormones: α-MSH, β-MSH, and γ-MSH) as well as the adrenocorticotropin hormone (ACTH) in skin pigmentation, adrenal steroidogenesis, and stress response. Three melanocortin receptor genes (MC1R, MC2R, and MC5R) contribute to the risk of major depressive disorder (MDD), and one melanocortin receptor gene (MC4R) contributes to the risk of type 2 diabetes (T2D). MDD increases T2D risk in drug-naïve patients; thus, MDD and T2D commonly coexist. The five melanocortin receptor genes might confer risk for both disorders. However, they …

Robotic Table And Serious Games For Integrative Rehabilitation In The Early Poststroke Phase: Two Case Reports, Grigore Burdea, Nam Kim, Kevin Polistico, Ashwin Kadaru, Namrata Grampurohit, Jasdeep Hundal, Simcha Pollack

Department of Occupational Therapy Faculty Papers

Background: BrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games.

Objective: The aim of this study is to design and test a robotic rehabilitation table-based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase.

Methods: A new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after …

Cerebral Blood Flow And Brain Functional Connectivity Changes In Older Adults Participating In A Mindfulness-Based Stress Reduction Program, Aleeze Sattar Moss, Diane K. Reibel, Nancy Wintering, Faezeh Vedaei, Hannah Porter, Mohsen Khosravi, Justin Heholt, M. Alizadeh, Feroze Mohamed, Andrew B. Newberg

Department of Radiology Faculty Papers

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.