Medicine and Health Sciences Commons^™

An Assessment Of The Reliability Of Platelet-Associated Flags Generated By The Sysmex Xe-5000 Automated Hematology Analyzer In Detecting Platelet Clumps, Jennifer M. Hawkins, Do, Gene Gulati, Ph.D, Guldeep Uppal, Md, Jerald Z. Gong, Md

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

XE-5000 is an automated hematology analyzer utilized by clinical laboratories worldwide to perform CBC and differential leukocyte counts on EDTA-anticoagulated blood specimens. The overall reliability of the results generated by this analyzer has been assessed and found acceptable for clinical use. The CBC results generated on some of the blood specimens are, however, flagged by the analyzer for verification of the result of the flagged parameter by other means. One such parameter of clinical significance is the automated platelet count, which is often unreliable if the blood specimen contains platelet clumps.

Experiential Global Health Education For The Health Professions: Lessons Learned From Experience-Based Learning For Students And Healthcare And Population Health Professionals, Rob Simmons, Drph, Mph, Mches, Cph, James Plumb, Md, Mph, Lucille Pilling, Edd, Mph, Rn, Ellen Plumb, Md

College of Population Health Lectures, Presentations, Workshops

Purpose:

• Describe key components of developing and sustaining a global health experiential learning experience

• Global Health Education for the Health Professions
• An area for multi-disciplinary study, research, and practice that places priority on achieving equity in health for all people worldwide
• Emphasizes transnational health issues, determinants, and solutions that promote interdisciplinary collaboration providing a synthesis of population based prevention, often including individual-level education and healthcare

Loss Of Expression Of Swi/Snf Chromatin Remodeling Complex Components And Setd2 Are Heterogeneous, Widespread, And Co-Occur In Clear Cell Renal Cell Carcinoma, Wei Jiang, Md, Phd, Essel Dulaimi, Theodore Parsons, Qiong Wang, Karthik Devarajan, Raymond O'Neill, Charalambos C. Solomides, Md, Stephen C Peiper, Phd, Jospeh R. Testa, Robert Uzzo, Haifeng Yang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

The subunits of the SWI/SNF chromatin remodeling complex have one of the highest mutation rate in human cancers (see Figure 1). Polybromo-1 (PBRM1), a subunit of the SWI/SNF complex, is the second most mutated gene (40%) in clear cell Renal Cell Carcinoma (ccRCC). ARID1A, another subunit that competes with PBRM1 for binding to the complex, was infrequently mutated. The protein expressions of BRG1 and BRM (two catalytic subunits of the complex), and SETD2, a histone modifier (10-15% mutation rate), are not known in ccRCC. In this study we examined their protein expressions by immunohistochemistry (IHC) in tissue microarrays (TMAs), …

Phylogenetic Tree Construction And “Truncal Loss” Analysis Reveal Hidden Associations Between Loss Of Protein Expression In Swi/Snf Complex Components And Tumor Stage And Survival In Clear Cell Renal Cell Carcinoma (Ccrcc), Wei Jiang, Md, Phd, Essel Dulaimi, Karthik Devarajan, Qiong Wang, Raymond O'Neill, Charalambos C. Solomides, Md, Stephen C Peiper, Phd, Robert Uzzo, Joseph R. Testa, Haifeng Yang, Phd

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

Polybromo-1 (PBRM1), a targeting subunit of the SWI/SNF chromatin remodeling complex, is mutated at a rate of ~40% in clear cell Renal Cell Carcinoma (ccRCC), second only to VHL. Whether its mutation is correlated with tumor stage is controversial. As other components of the SWI/SNF complex were also reported to be mutated in ccRCC, we aim to examine the protein expression patterns of PBRM1, ARID1A, BRG1, and BRM in ccRCC, and to investigate possible association between their loss of expression and tumor stage, as well as survival. We also included a histone modifier, SETD2, which is recently discovered to …

Assessment For Risk Factors Associated With Local Recurrence In Chordoma, John A. Abraham, Md, Wei Jiang, Md, Phd

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

Chordoma is a rare but locally aggressive malignant neoplasm showing notochordal differentiation. The clinical differential diagnoses can be extensive, and definitive diagnosis often relies on histopathologic evaluation. Histologically, chordoma shows dual epithelial and mesenchymal differentiation, with various morphologies. Despite surgical resection and use of adjuvant radiation therapy, the local recurrence rate of chordoma remains high. We aim to establish factors associated with the increased risk of recurrence and help guide treatment decisions.

Pathology Encountered During Cadaver Dissection Provides An Opportunity For Integrated Learning And Critical Thinking, Guiyan Zhang, Bruce Fenderson

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Abstract

Cadaver dissection engages medical students in active learning, critical thinking, and problem solving. During dissection, students at SKMC are encouraged to document pathologic findings in their cadavers and discuss the findings with their peers. Here, we describe two cases that provided opportunities for integrating anatomy with pathology and clinical medicine. The first case was a benign ovarian neoplasm. This large pelvic mass displaced the urinary bladder and uterus, and compressed the ureters and rectum. Students discussed clinical complications of this pelvic mass and reviewed pathologic findings that differentiate benign from malignant neoplasms. The second case was breast cancer with …

Age-Related Ebv-Associated Lymphoproliferative Disorder With Widespread Gastrointestinal Involvement And Subsequent Development Of T-Cell Lymphoma, Guldeep Uppal, Md, Alaina Chodoff, Msii, Zi-Xuan Wang, Phd, Jeffrey P. Baliff Md, Jerald Z. Gong, Md

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

Age-related EBV-associated lymphoproliferative disorder (AR-EBVLPD) has emerged as a new subset of B-cell lymphoproliferative disorders. We report a unique case of AR-EBVLPD with a widespread gastrointestinal presentation and subsequent transformation to EBV-associated T-cell lymphoma. To our knowledge, this is the first report of a generalized polymorphic extranodal AR-EBVLPD with subsequent transformation to EBV-induced T-cell lymphoma.

Addressing Hispanic Adolescent Mental Health In The Texas Border Region: A Policy Analysis, Brian Zepka

Master of Public Health Capstone Presentations

Distinguished MPH Capstone Project 2015

The Texas border region experiences adverse cultural, socioeconomic, environmental, and political challenges that influence the mental health status of adolescents living along the border. The purpose of this research was to provide informed advice to relevant policy makers and facilitate decision-making concerning access to culturally competent mental health services for Hispanic adolescents in this region. A systematic literature review was performed to assess the evidence of barriers these adolescents face when accessing mental health services. Interviews with relevant key stakeholders in the region were then conducted to identify their perspectives on barriers to care. The …

Population Health: Where's The Beef?, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

The Patient Burden Of Screening Mammography Recall., Matthew Alcusky, Liane Philpotts, Machaon Bonafede, Janice L. Clarke, Alexandria Skoufalos

College of Population Health Faculty Papers

OBJECTIVE: The aim of this article is to evaluate the burden of direct and indirect costs borne by recalled patients after a false positive screening mammogram.

METHODS: Women aged 40-75 years undergoing screening mammography were identified from a U.S. commercial claims database. Women were required to have 12 months pre- and 6 months post-index enrollment to identify utilization and exclude patients with subsequent cancer diagnoses. Recall was defined as the use of diagnostic mammography or breast ultrasound during 6 months post-index. Descriptive statistics were presented for recalled and non-recalled patients; differences were compared using the chi square test. Out-of-pocket costs …

Understanding Patient Options, Utilization Patterns, And Burdens Associated With Breast Cancer Screening., Susan C Harvey, Ashok Vegesna, Sharon Mass, Janice L. Clarke, Alexandria Skoufalos

College of Population Health Faculty Papers

Abstract Despite ongoing awareness, educational campaigns, and advances in technology, breast cancer screening remains a complex topic for women and for the health care system. Lack of consensus among organizations developing screening guidelines has caused confusion for patients and providers. The psychosocial factors related to breast cancer screening are not well understood. The prevailing algorithm for screening results in significant rates of patient recall for further diagnostic imaging or procedures, the majority of which rule out breast cancer rather than confirming it. For women, the consequences of the status quo range from unnecessary stress to additional out-of-pocket expenses to indirect …

Knowledge And Perceived Barriers About Diabetic Retinopathy And Dilated Eye Exam In Patients With Diabetes, Manisha Verma, Md, Mph, Mona Sarfaty, Robert Simmons, Drph, Mph, Albert Crawford

Mona Sarfaty

Conclusions:

• The results of this study suggest that 68% of the population from this primary care practice got a dilated eye exam within a year. Facilitators were awareness/knowledge about the DR and DFE, eye problems and information from their doctors.
• Almost 20% of the patients did not get an eye exam as recommended. Various barriers included cost, transportation issues, time constraint issues, lack of symptoms of the disease, and fear of the exam.
• There is a significance difference in getting an eye exam by the type of insurance with a smaller percentage of Medicaid recipients (60%) meeting the guidelines compared …

Insights From "Creating The Healthcare Workforce For The 21(St) Century" Conference., Amanda R Solis

College of Population Health Faculty Papers

No abstract provided.

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

The 46th Actuarial Research Conference, Poster session I, University of Connecticut, Storrs, CT. August 11, 2011.

Poster conclusions:

• U.S. spending is high.
• Long tailed medical linked insurance may be easier to write in the U.S.
• U.S. healthcare cost curve is not outrageous.
• Average spending
• Low volatility

Poster is associated with this paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section.9th International Conference on Health Policy Statistics, Cleveland, OH.

14 PowerPoint slides

Presentation associated with this paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/.

Strategies For Financing Healthcare Costs Over The Long Term., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section. 9th International Conference on Health Policy Statistics, Poster session I, Cleveland, OH.

Funding to support this work came from AHRQ grant R36 HS018835-01.

Policy Implications:

-Health insurance companies should use a broad, diversified investment portfolio as their optimal investment strategy -Insurance regulators should be focused on longer term lines of health insurance

High Frequency Evidence On Variation In Spending Growth., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Statistical Association Health Policy Statistics Section. 9th International Conference on Health Policy Statistics, Poster session I, Cleveland, OH.

Policy Implications:

• Health insurance regulation should include compensation for taking on riskier groups.
• Health programs should focus on changing needs for risk management versus health management throughout the life cycle.

Funding to support this work came from AHRQ grant R36 HS018835-01.

Validating The Pridit Method For Determining Hospital Quality With Outcomes Data., Robert D. Lieberthal, Phd, Dominique Comer, Pharmd, Katherine O’Connell, Bs

College of Population Health Lectures, Presentations, Workshops

Presented for The 46th Actuarial Research Conference, University of Connecticut, Storrs, CT.

15 PowerPoint slides

International Evidence On Medical Spending Risk., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the American Risk and Insurance Association. 2011 ARIA Annual Meeting, San Diego, CA.

20 PowerPoint slides.

Presentation is associated with the paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/

Knowledge And Perceived Barriers About Diabetic Retinopathy And Dilated Eye Exam In Patients With Diabetes, Manisha Verma, Md, Mph, Mona Sarfaty, Robert Simmons, Drph, Mph, Albert G. Crawford

College of Population Health Lectures, Presentations, Workshops

Conclusions:

• The results of this study suggest that 68% of the population from this primary care practice got a dilated eye exam within a year. Facilitators were awareness/knowledge about the DR and DFE, eye problems and information from their doctors.
• Almost 20% of the patients did not get an eye exam as recommended. Various barriers included cost, transportation issues, time constraint issues, lack of symptoms of the disease, and fear of the exam.
• There is a significance difference in getting an eye exam by the type of insurance with a smaller percentage of Medicaid recipients (60%) meeting the guidelines compared …

Got Worms?: Planning And Evaluation Of A Culturally Appropriate Health Education Pilot Program For The Control Of Soil-Transmitted Helminth Infections In Rwandan Village Children, Pier Hart

Master of Public Health Capstone Presentations

Infections with parasitic intestinal worms known as soil-transmitted helminthes (STH) are endemic in most poor countries in Africa, Asia and Latin America. In Rwanda, the prevalence of helminth infections among school-age children was found to be nearly 70%. Chronic STH infections are associated with malnutrition and anemia, which cause physical and cognitive developmental problems. These morbidities negatively affect educational attainment and vocational productivity and thereby perpetuate the cycle of poverty in affected communities. Control of STH requires both regular deworming treatments and changes in health behaviors relevant to transmission, including personal hygiene and sanitation practices. In Rwanda, a nationwide program …

The Need For A Sugar-Sweetened Beverage Tax In Philadelphia – Policy Analysis, J M. O'Dell

Master of Public Health Capstone Presentations

The goal of this study was to analyze sugar-sweetened beverage tax policy as one strategy to fight America’s obesity epidemic. Obesity is an enormous problem that plagues individuals worldwide. The prevalence of obesity is high in this country, exceeding 25% in 33 states. In Pennsylvania in 2009, 27.7% of adults were labeled as obese. Additionally, there are many more Philadelphians who are overweight or obese (900,000) than who are at a healthy weight (600,000). Obesity is extremely complex and has several causes. One cause of obesity and the main concern of this study is the consumption of sugar-sweetened beverages. Sugar-sweetened …

Assessing Nutrition Knowledge, Skill And Attitudes In Adolescent Girls, Tatyana Jean

Master of Public Health Capstone Presentations

There is still much to be understood about the nutrition habits of adolescents who are just beginning to break away from familial habits and developing individual identities. The African American community in particular, is known to experience disproportionate amounts of overweight and obesity resulting in chronic diseases such as diabetes and hypertension. This study used quantitative and qualitative measures to assess the nutrition skills, knowledge, and attitudesof African American girls aged 14-17. After data analysis, it was found that African American adolescent girls had high body image and self esteem but poor nutrition skill and knowledge. Body image and weight …

International Evidence On Medical Spending., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the Casualty Actuarial Society 2011 Seminar on Reinsurance, Philadelphia, PA.

Handouts are also available at: http://www.casact.org/education/reinsure/2011/handouts/C17-Lieberthal.pdf

the audio is available at: http://www.casact.org/education/reinsure/2011/audio/C17.mp3

and it is associated with the paper: http://jdc.jefferson.edu/healthpolicyfaculty/45/

23 PowerPoint slides.

Detecting Hospital Quality With Pridit., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the Temple University, Fox School of Business Department of Risk, Insurance & Healthcare Management. Robert A. Hedges Research Seminar Series, Philadelphia, PA.

25 PowerPoint slides

Associated papers available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2007.00821.x/abstract

and the 2008 Proceedings of the Joint Statistical Meeting.

Finding High Quality Hospitals In Philadelphia., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Guest lecture for PBH609 GIS Mapping. Fall, 2010 session. Philadelphia, PA.

15 PowerPoint slides.

Download Full Pdf Issue Of Jefferson School Of Population Health Master Of Public Health E-News Public Health Link, Vol. 6, Iss. 2, Summer 2010

Public Health Link

This issue includes a MPH spotlight on JoAnne Fischer, Executive Director of the Maternity Care Coalition (MCC). Other articles include: 13th Annual Health Education Advocacy Summit Student Perspectives, Health Reform Provides Major Benefits to Public Health summary, Food Inspection Opportunity, congratulations to Spring Capstone presenters, and information on 2 symposia: Symposium on Community Based Participatory Research on Chronic Disease Prevention and Symposium on National Public Health Week - One Community at a Time.

Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management. Report On The Us Summit., Janice L Clarke

College of Population Health Faculty Papers

Report on the US Summit