Medicine and Health Sciences Commons^™

Analysis Of Self-Reported Walking For Transit In A Sprawling Urban Metropolitan Area In The Western U.S., Courtney Coughenour, Hanns De La Fuente-Mella, Alexander Paz

School of Public Health Faculty Research

Walkability is associated with increased levels of physical activity and improved health and sustainability. The sprawling design of many metropolitan areas of the western U.S., such as Las Vegas, influences their walkability. The purpose of this study was to consider sprawl characteristics along with well-known correlates of walkability to determine what factors influence self-reported minutes of active transportation. Residents from four neighborhoods in the Las Vegas Metropolitan Area, targeted for their high and low walkability scores, were surveyed for their perceptions of street-connectivity, residential-density, land-use mix, and retail–floor-area ratio and sprawl characteristics including distance between crosswalks, single-entry-communities, high-speed streets, shade, …

Developing Kinesthetic Classrooms To Promote Active Learning, Brian Culp

Faculty Articles

The use of kinesthetic movement in the classroom toward improving health and educational outcomes among youth has been a topic of discourse in recent years. School initiatives that have infused movement as part of the curriculum have shown to increase efficiency in learning, while decreasing stress and contributing to a positive classroom climate. One question that is worthy of exploration pertains to how future professionals in the fields of physical education and health can promote kinesthetic movement in schools and communities. This article discusses how a university kinesthetic classroom prepares future professionals to be advocates for school health using active …

The Impact Of Student Hotspotting On Patients & The Jefferson Health System, Mishael Khan, Bs, Lauren Collins, Md, Shoshana Sicks, Edm, Richard Hass, Phd, Tracey Vause Earland, Phd, Otr/L, Courtney Newsome, Ba, Sara Cohen, Ots

Phase 1

Introduction

“Super-utilizers”, patients with five or more hospital admissions in the past year, account for half of all healthcare expenditures and present a significant financial burden to our healthcare system. In Pennsylvania “super-utilizers” result in $1.25 billion of healthcare spending and Philadelphia has the highest number of “super-utilizers” in the state. To address this crisis, Jefferson University serves as one of four new national hubs for student hotspotting. Teams of interprofessional health professions students along with faculty and staff advisors enroll “super-utilizers” and provide targeted interventions to address social determinants of health, reduce hospitalizations and improve patient outcomes.

Methods

To …

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Emily Wei, Katie Holland, Allison Zibelli, Md

Phase 1

Introduction: Readmission rates of cancer patients remain high, while the rates of many other conditions are decreasing in the United States. Cancer patients are a plurality of patients readmitted to hospitals within 30 days of discharge, and have a high rate of avoidable readmission. Therefore, it is important to understand why these readmissions happen in order to prevent their occurrence.

Objective: This study hopes to identify specific, and potentially personal, reasons that bring cancer patients back to the hospital. Patient perspective may reveal trends that are not apparent in medical record chart reviews. This information can present an opportunity to …

Adaptive Statistical Iterative Reconstruction-V For Lung Nodule Analysis, Cherry Au, Zhenteng Li, Md, Eric Gingold, Md, Ethan Halpern, Md, Baskaran Sundaram, Md

Phase 1

Introduction: Low-dose CT in lung cancer screening has demonstrated benefits in select patients. As the traditional filtered back projection (FBP) technique is limited by poor image quality, adaptive statistical iterative reconstruction-V (ASIR-V) algorithm has been developed to achieve higher image quality with processing efficiency.

Objective: To investigate the impact of various CT scan parameters on the semi-automated measurement of lung nodules using a Computer Aided Detection (CAD) program.

Methods: This IRB-exempt phantom experiment was conducted with a CT scanner capable of ASIR-V algorithm. Eight lung nodules sized 5-12 mm, of solid or ground glass type, were placed inside a multipurpose …

Diagnostic Accuracy Of Home Sleep Apnea Testing (Hsat) Based On Recording Duration, Angela Alnemri, Theodora Fynn, Prakash Vasudevan, Ritu Grewa, Karl Doghramji

Phase 1

Introduction: Obstructive Sleep Apnea (OSA) is a chronic sleeping disorder with serious health consequences. Currently, standard diagnosis is through in-lab polysomnography; however, there has been a shift to greater use of Home Sleep Apnea Testing (HSAT) for patients with a high pre-test probability of having OSA.

Objective: To investigate the minimum recording time needed during HSAT to accurately diagnose the presence and severity of OSA.

Methods: A retrospective review was conducted of HSATs done from January-October 2017. Each study was divided into 1-, 2-,3-,4-,5-, 6-, and 7 hour intervals beginning at the recording start time. The respiratory event index (REI) …

Effect Of Tort Reform On Diagnostic Imaging Rates, Israel Ojalva, Ba, Arthur Hong, Md, Mph

Phase 1

Introduction: Defensive medicine, is defined as “order[ing] tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not solely) because of concern about malpractice liability.” Nearly all physician who fear malpractice litigation have admitted to practicing some degree of defensive medicine. In response, many states have enacted policy reforms to lighten the threat of malpractice on physicians.

Objective: The most common defensive medicine behavior is ordering diagnostic imaging tests when it is potentially unwarranted. Many states have enacted non-economic damage caps from 2000-2010. We explored if these laws had an impact on the rates of diagnostic imaging …

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Katie Holland, Emily Wei, Allison Zibelli

Phase 1

While there are large efforts to decrease readmission rates in the United States, cancer patients represent a population that has been overlooked. Cancer patients are a vulnerable population who make up a large portion of hospital readmissions. Most of the current research on the causes of readmissions in cancer patients focuses on medical chart reviews and insurance claims. Many of these studies fail to incorporate patient input which could further the understanding of the complete burden associated with cancer readmissions. The goal of this study is to understand the personal reasons behind the decision of cancer patients to return to …

Enhancing Services For Homeless Populations: Impact Of A Virtual-Reality Training Tool On Health Professional Students’ Self-Efficacy In Working With Homeless Populations, Madeline Russell, Susan Toth-Cohen, Phd, Otr/L

Phase 1

INTRODUCTION

Despite the rising prevalence and unmet healthcare needs of homeless populations, most healthcare providers do not receive specific training on working with this population. The growth of simulation-based technology in the medical classroom offers new opportunities for such training. Virtual-reality tools have been shown to facilitate learning and minimize restraints such as time and travel. The Enhancing Service to Homeless Populations (ESHP) program was designed to provide health professions students at Thomas Jefferson University with training on how to interact with homeless populations using an interprofessional virtual-reality setting, with the ultimate goal of improving students’ self-efficacy.

METHODS

Participants (n=15) …

A Multicomponent Quality Improvement Project To Improve Sleep In Hospitalized Patients: A Single Center Pilot Experience, Michelle Konkoly, Alan Kubey, Md

Phase 1

No abstract provided.

A Qualitative Evaluation Of The Interprofessional Student Hotspotting Learning Collaborative: Perceptions Of Student And Faculty Advisor Participants, Ashley Traczuk, Bsn, Rn, Angela Gerolamo, Phd, Rn, Elena Umland, Pharmd

Phase 1

Introduction: Student participation in interprofessional education has proven beneficial in regards to students’ understanding of professional roles, team situational awareness¹,and appreciating the need for collaboration². The interprofessional student hotspotting learning collaborative enables students to work in teams to help serve patients categorized as health-system “super-users”, defined as those who overuse inpatient and/or emergency hospital services, over a period of six months’ time. This model will allow students to have real patient encounters and to begin utilizing their own roles within interdisciplinary teams.

Objective: This study aims to evaluate the impact of the interprofessional student hotspotting learning …

Total Body Skin Exam And Number Needed To Screen, Audra Hugo, Michael Bui, Alexander Sherban, Shayan Waseh, Elizabeth Jones, Md

Phase 1

Introduction/Background: Skin cancer screening could impact mortality and morbidity in US adults; however, the effectiveness of widespread screening remains unclear. Further research is necessary to determine what age groups, with what risk factors, might benefit from routine total body skin exams (TBSE) in the US.

Objective: This study sought to determine, on average, the number of patients, per decade, needed to screen via TBSE to identify one person with skin cancer.

Methods: A retrospective review of Jefferson Dermatology outpatient data in Epic was conducted. All patient charts from 1/1/2017 - 1/1/2018 were reviewed if they received a TBSE. The type …

Outcomes Reporting In Regional Anesthesia Patients: A Comparison Of Manual Phone Calls Versus Automated Phone App Messaging, Gavyn Ooi, Mba, Eric Schwenk, Md, Fasa, Jeffrey Mojica, Do, Alexander Grant, Md, Max Shilling, Md, David Barnabei, Md, Jennifer Lessin, Ba, Rn, Ccrc, Marc Torjman, Phd, Kent Berg, Md, Mba

Phase 1

Automation of patient follow-up via mobile phone apps have the potential to save time for physicians, standardize responses from patients, and increase the patient response rate. Studies that assess the effectiveness of mobile phone-based surveys have been favorable, with completion rates of about 60% in the surgical population. The impact of mobile phone-based patient management in anesthesia deserves further study. This study examines the follow-up success rates of (1) manual phone calls (the current standard of care) vs. (2) automated patient outreach (APO) in patients who receive a regional anesthesia block procedure.

As part of normal follow up, anesthesia team …

Mindfulness-Based Stress Reduction Intervention For The Treatment Of Chronic Pain In The Elderly, Austin Roadarmel, Diane Reibel, Phd, Aleeze Moss, Phd, Andrew Newberg, Md

Phase 1

One of the most common complaints of adults in their 80s and above, a growing portion of our population, is chronic pain and it is often inadequately treated. A secular mindfulness-based stress reduction (MBSR) program was developed by Jon Kabat-Zinn in 1979 and has since shown measurable benefits to individuals in decreasing depression, pain, and anxiety. Considering the significant risk of side effects and age-associated changes of pharmacodynamics and pharmacokinetics in the traditional pharmacologic approach to chronic pain in the elderly, non-pharmacologic intervention such as MBSR may be particularly effective for the elderly population.

Methods: We conducted a 6 week, …

An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd

Phase 1

Introduction: The utilization of ultrasound-guided peripheral nerve blocks in orthopedic surgery has increased in popularity as the anesthesia of choice for the management of perioperative pain. Peripheral nerve blockade has been shown to increase overall surgical efficiency, improve patient satisfaction, reduce postoperative narcotic use, and decrease the duration of facility admissions, while increasing overall cost-effectiveness. To date, scant literature exists regarding the safety and efficacy of ultrasound-guided supraclavicular blocks used in common hand surgery procedures, and the rate of neurologic and vascular complications remains unknown.

Objective: The purpose of this study was to examine the effectiveness and complication rate of …

Risk Factors For Boating Incidents In Inuvik, Northwest Territories, Canada, Catherine Tr Glass, Audrey R. Giles

International Journal of Aquatic Research and Education

Injury prevention programs that focus on boating and water safety in the Northwest Territories (NWT) have existed for decades; however, rates of boating incidents are much higher in the NWT than southern Canada. To better understand this health disparity, we engaged in community-based participatory research informed by postcolonial feminist theory to examine Aboriginal men’s understandings of the risk factors that contribute to boating incidents in Inuvik, NWT. Participants identified four main risk factors for boating incidents in Inuvik: 1) Gender, 2) age, 3) place, and 4) lack of boating safety education. As a result of these findings and the ways …

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 …

Collaborating To Develop And Implement A Family Bike Program., Jamie Hunsicker

Nursing Faculty Scholarship

No abstract provided.

Perfluoroalkyl Substances Exposure And Cancer In Nhanes 2011-2016 U.S. Population, Michael Crowder

Master of Public Health Program Student Publications

Background: Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are persistent synthetic compounds that may have associated health risks.

Purpose: To explore the association between four common detectable serum PFASs perfluorooctanoic acid (PFOA), perfluorooctyl sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) and cancer risk in United States (U.S.) adults.

Methods: Data from 4,497 participants from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Gender stratified adjusted logistic regression analysis was conducted to determine association between serum PFASs tertiles and risk of cancer.

Results: Median (IQR) PFASs were significantly higher in men compared to women, and among individual with …

Depictions Of Genetic Research In Film Across Film Genres, Jennifer Lund

Undergraduate Honors Theses

When people do not have personal experience to draw on, the experiences of characters in film can serve in the mind as a substitute. This research sought to determine what kind of impression films depicting genetics research leave on the audience. These genres were romance (Code 46, 2004), horror (Splice, 2009), thriller (Children of Men, 2006), and drama (Gattaca, 1997). Scenes from the films were analyzed to determine their likely effect on the audience perception of genetics. The researcher hypothesized that the drama and romance films would portray genetics research as neutral, but the science …

Evaluability Assessment Of “Growing Healthy Communities,” A Mini-Grant Program To Improve Access To Healthy Foods And Places For Physical Activity, Christiaan G. Abildso, Angela Dyer, Shay M. Daily, Thomas K. Bias

Faculty & Staff Scholarship

Mini-grants have been used to stimulate multisector collaboration in support of public health initiatives by funding non-traditional partners, such as economic development organizations. Such mini-grants have the potential to increase access to healthy foods and places for physical activity through built environment change, especially in small and rural towns in the United States. Although a promising practice, few mini-grant evaluations have been done. Therefore, our purpose was to conduct an Evaluability Assessment (EA), which is a process that can help promising programs that lack evidence advance toward full-scale evaluation. Specifically, we conducted an Evaluability Assessment of a statewide mini-grant program, …

Lead Exposure And Metabolic Syndrome In U.S. Population, Nhanes 2013-2014, Khadra Gukadowr

Master of Public Health Program Student Publications

Background: Lead is a known endocrine disruptor and can impair regulation of blood glucose, blood pressure, abdominal adiposity, blood lipid levels which are risk factors for metabolic syndrome (MetS).

Objective: To study the association of lead exposure and MetS in United States (U.S.) adults.

Methods: Data from 523 male and 528 female participants aged 20 years and older from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Based on blood lead distribution in males and females, participants were categorized into low and high blood lead groups in both genders. Adjusted logistic regression analysis was used …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

The Clinical Laboratory Workforce In New York State : A Study Of Supply And Demand, Stephanie H. Shulman

Legacy Theses & Dissertations (2009 - 2024)

ABSTRACT

Right Size Me : Policy Responses To The Obesity Eidemic And Behavioral Change, Wenhui Feng

Legacy Theses & Dissertations (2009 - 2024)

Obesity is a critical health and social concern. Almost 40% of American adults are obese, creating more than $300 billion dollars in annual medical costs. While obesity is a public concern that has been on the policy agenda for some time, obesity policies have proven difficult to formulate, adopt and implement in practice. In this dissertation, I explore three obesity-related policies – adoption of obesity prevention policies by local health department, calorie labeling on restaurant menus and food assistance benefits – and find the importance of ideological and political considerations for obesity policies at different stages in the policy process …

Signs Of Humanity – A Researcher-Artist Collaboration, Katherine Brierly, Steven Buffer, Kaela Edwards, Zach Fusfeld, Jenna Garret, Nisha George, Katie Holland, Nichole Holmes, Josephine Hwang, Alyssa Tate, Emily Wei, Rosemary Frasso, Willie Baronet

JCPH at APHA 2019

A team of Jefferson students, alumni and faculty in collaboration with artist Willie Baronet, employed qualitative methods to explore poverty in Philadelphia.

Background

The Signs of Humanity (SOH) Project is a researcher-artist collaboration. This joint venture was designed to explore the interactions between people using signs to ask for help and those who pass by with the goal of reducing the dehumanization of this community. The research arm was designed to qualitatively explore the experiences of people who seek financial support or in-kind help from passersby. This is referred to as "panhandling" in the literature and that term will be …

Occupational Health And Safety Implementation Issues In Egypt / مشكلات تطبيق الصحة والسلامة المهنية في مصر, Nihal Hatem Said, Nourhan Fahmy, Ossama Hanafy

Papers, Posters, and Presentations

This policy paper addresses the current OHS implementation issues in Egypt and situates them within a global context that comprises agreed upon international safety regulations, conventions and management systems as well as international certification such as the ISO. Through a review of the implementation process of OHS in Egypt, complex legal, institutional and technical issues arise, illuminating the deficiencies present in the current OHS policy framework. This paper delves into the shortcomings present in the documentation and inspection processes that represent a cornerstone of the overall implementation of OHS standards whether by the government or the private sector.

Pilot Gwas Of Caries In African-Americans Shows Genetic Heterogeneity, E. Orlova, J. C. Carlson, M. K. Lee, E. Feingold, D. W. Mcneil, R. J. Crout, R. J. Weyant, M. L. Marazita, J. R. Shaffer

Faculty & Staff Scholarship

Background

Dental caries is the most common chronic disease in the US and disproportionately affects racial/ethnic minorities. Caries is heritable, and though genetic heterogeneity exists between ancestries for a substantial portion of loci associated with complex disease, a genome-wide association study (GWAS) of caries specifically in African Americans has not been performed previously.

Methods

We performed exploratory GWAS of dental caries in 109 African American adults (age > 18) and 96 children (age 3–12) from the Center for Oral Health Research in Appalachia (COHRA1 cohort). Caries phenotypes (DMFS, DMFT, dft, and dfs indices) assessed by dental exams were tested for association …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …

A Web-Based Dietary Intervention In Early Pregnancy And Neonatal Outcomes: A Randomized Controlled Trial, Rachel Ak Kennedy, C.M.E. Reynolds, Shona Cawley, E. O'Malley, D.M. Mccartney, M.J. Turner

Articles

Background Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes.

Methods Women < 18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women.

Results Of the 250 women, there were no differences in characteristics between the two groups. Of the women, 91.0% reported they make a conscious effort currently to eat a healthy diet. However, only 19.6% met dietary requirements for calcium, 13.2% for iron, 2.7% for folate and 2.3% for iodine. The most popular website section was pregnancy …