Medicine and Health Sciences Commons^™

Moyamoya Disease And Acute Inpatient Rehabilitation In A 17-Month Old Previously Healthy Male, Cassandra Coleman, Nicole Marcantuono

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Case Diagnosis

17-month old male with newly diagnosed MoyaMoya after presenting with new onset seizures and right-sided weakness.

Case Description

MoyaMoya is a rare cerebrovascular condition predisposing patients to stroke in association with progressive stenosis of the intracranial internal carotid arteries and their proximal branches.

The patient presented initially after a fall with subsequent inability to bear weight on his right leg along with minimized use of his right arm. Patient was treated for a suspected tibial Salter-Harris II and nursemaid’s elbow. He presented four days later to the ED with new onset seizures. CT of the brain showed loss …

Adolescent Pregnancy In Ecuador, Paige Bates

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Description of the Problem

• Teen pregnancy, commonly defined as pregnancy in a girl less than 18 or 19 years of age, is often a target of public health efforts because of the far-reaching economic, social and health effects.¹
  • A girl who becomes pregnant attends 2.5 less years of school, and each additional child translates into 1 less year of education.²
  • Girls who get pregnant before age 18 are more likely to experience violence within marriage or a partnership than girls who postpone child-bearing.¹
  • Babies born to adolescent mothers have a higher incidence of perinatal complications (like asphyxia …

An Interdisciplinary Approach To Combat Obesity In The Galapagos, Christopher Busack, Bethany Fox

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Galapagos Background

• Total Population (2010) = 25,124¹
• Largest city = Puerto Ayora (Santa Cruz)
• Average monthly income in Galapagos = $772.03/month²
• Average monthly income in mainland Ecuador = $251.70/month²
• Booming tourism industry contributes to rapid population growth³

4 of 18 main islands (>1km²) open for human residence (Santa Cruz, Isabela, San Cristobal, Floreana)

Addiction: A Treatable Disease, Nathaniel Graham

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Addiction: Definitions and Statistics

Nearly 1 in 7 Americans (~40 million people) are addicted to a chemical substance.

An additional 2 in 7 Americans (~80 million people) qualify as risky substance users; those who use chemical substances in ways that threaten their health and safety.

Regional Disparities In Neurocritical Care Outcomes, Kali Graham

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BACKGROUND

• Determinants of Neurocritical Care Outcomes: Social as opposed to biological disparities can frequently dictate health outcomes for neurocritically ill patients. Survival rates are determined both by a patient’s access to a NCU (Neurocritical Care Unit) as well as the level of inpatient care he or she receive once admitted to a NCU.
• Regional Inequality in Access to Care¹:
• Only 12.8% of Americans have access to a NCU within 45 min by ground transportation and 36.8% have access to a NCU within 45 minutes by air transportation.
• Racial Disparities in NCU Admissions and Outcomes²:
• Non …

Underrepresented Minorities And Jefferson Medical System Healthcare: What Can We Do To Diversify The Physician Workforce?, David Halpen

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Why Diversity?

• An increasingly diverse workforce leads to better levels of care.¹
• Underserved areas need better care and this is currently not being provided by Physicians from non URM backgrounds. ²
• Research shows that physicians from diverse backgrounds are more likely to return to service the communities of underrepresented minorities (URMs). ³
• There will be a decrease in overall healthcare disparities between different groups. ⁴

Care With Dignity: Understanding How To Care For Hiv Positive And Formerly Incarcerated Populations, Caroline Komanecky, Terry Trudeau, Med, James D. Plumb, Md, Mph, Helen Koenig, Md

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Philadelphia FIGHT is a comprehensive HIV/AIDS service organization providing primary care, consumer education, advocacy, and research on potential treatments and vaccines. FIGHT was formed as a partnership of individuals living with HIV/AIDS and clinicians, who joined together to improve the lives of people living with the disease. Today, FIGHT serves an even broader patient population and recently received designation as a Federally Qualified Health Center. FIGHT strives to address not only HIV-infected patients, but all at-risk populations through education, outreach, and preventative medicine. The annual Bridging the Gaps interns are responsible for several projects, including a client satisfaction survey, a …

Lgbt Healthcare And Our Role In Smoking Cessation, Leor Krichilsky, John Covotta, Valerie Canavin, Rickie Brawer, Mph, Phd, Robert Winn, Md, Ms, Aahivs

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Mazzoni’s goal is comprehensive LGBT care

The interns learned the value of comprehensive care through observing roles of the nurses, transgender intake counselor, case managers, and physicians. Mazzoni’s multi-disciplinary model allows patients’ various needs to be met directly.

The interns also learned the importance of LGBT care through discussions about use of unisex bathrooms, preferred pronouns, and inclusive language. This is demonstrated by Mazzoni’s new patient forms.

Universal Healthcare: Costa Rica As A Model, Annie J. Ferris

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What it Looks Like in Costa Rica

• Run by the Costa Rican Social Security Administration
• Financed by employers, employees, and the Ministry of Health. Employer and employee contributions together make up over 90% of contributions.
• Costa Rica is divided into 105 health areas, which are further divided up into primary care units called Basic Provision Units of Integrated Healthcare, or EBAIS. There are 947 of these primary care centers throughout Costa Rica, and everyone is assigned to one.
• The EBAIS clinics provide a wide range of services to cover the general and specific health needs of the community, including primary …

Health Care In Bolivia: A First Hand Experience, Sanchi Malhotra

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This research project is based on a one month work experience in Cochabamba, Boliva through the NGO Sustainable Bolivia at Hosptial Viedma, a major public hospital and Centre de Salud Pacata, a rural outpatient health clinic. The information presented below is derived from both research and personal experience. This trip was partially funded by Jefferson Office of International Affairs with the goal of gaining experience and knowledge about the Bolivian health care system.

Establishing Roots In West Philadelphia, Nina Millman, James Larosa, Skip Weiner, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

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Urban Tree Connection

Urban Tree Connection is an organization that utilizes plots of land which have been abandoned. The organization uses the land to create gardens that grow produce which is then sold at markets and to the community. Their goal is to provide access to fresh fruits and vegetables in the food desert areas of West Philadelphia. Members of the community are able to get involved by allowing some of their land to be used as gardens and helping to maintain the sites. The organization also tries to spread information about sustainability including a compost program in the neighborhood.

Globally Minded, Locally Serving: Refugee Health In Philadelphia, Sarah Jamieson, Angelica Montes, Gretchen Shanfeld, Mph, Rickie Brawer, Mph, Phd, Caryn Johnson, Ms, Otr/L, Faota, James D. Plumb, Md, Mph

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Introduction

A refugee is someone who is forced to leave their country of origin due to war, violence, or persecution. The United States is the world’s top resettlement country. Out of the 50 states, Pennsylvania is 5^th in terms of the number of annually resettled refugees. Each year, Philadelphia resettles approximately 800 refugees. Bhutan, Burma, Iraq, Eritrea, Sudan, and Democratic Republic of Congo are the most frequent countries of origin in Philadelphia.

Healthy Habits, Happy Baby!, Amanda Ocran, Suvidha Polu, Joan I. Gluch, Phd, Rdh, James D. Plumb, Md, Mph, Rickie Brawer, Mph, Phd

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Cribs for Kids, a component program of the Maternity Care Coalition, provides needy families in Philadelphia with cribs and education on safe sleeping environments.

• Cribs for Kids also provides education on how to reduce the risk of sudden infant death syndrome (SIDS).
• The organization hosts workshops throughout the city and home visits for those who cannot attend the workshops.
• Cribs for Kids also increases awareness about safe sleeping habits and their program by attending community health fairs.
• In the last year Cribs for Kids has provided families the city of Philadelphia with over 2,000 safe sleeping environments.

The Effect Of Peer Educators On Medication Adherence In Hiv Patients In Cochabamba, Bolivia, George Ru

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BACKGROUND INFORMATION

• Bolivia is the least developed country in South America, with high levels of poverty, poor access to safe water, and low economic activity. Bolivia’s GDP, in US dollars, in 2013 was $30.60 billion and the gross national income, per capita in US dollars was $2,550, which both rank either at or near the bottom of the list for all South American countries (7).
• The Ministry of Health and Sports (MSD) is the national governing body responsible for formulating the strategy, policies, plans and programs in health. The Department of Health Services (SEDES) is the highest level of technical …

Bridging The Gaps Chip: Prevention Point, Patrick Prior, Clayton Ruley, Mss, Mlsp, Shp, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

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Prevention Point Philadelphia aims to reduce the harm associated with injection drug use and sex industry work through an array of harm reduction programs, including syringe exchange, condom distribution, naloxone rescue, social workers, and opioid replacement therapy.

The Heart Of Healthcare: The Role Of Authentic Relationships In Caring For Patients With Frequent Hospitalizations, Charlotte Weisberg, Ba, Margaret Hawthorne, Mph, Marianna Lanoue, Phd, Jeffrey Brenner, Md, Dawn B Mautner, Md, Ms

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INTRODUCTION

Frequent hospital utilization is a major contributor to the costs of healthcare. Despite a vast body of literature, there remains great uncertainty about the characteristics and care needs of individuals with frequent hospitalizations.^1,2 In the movement to reduce the need for hospitalizations, care management programs have garnered wide attention and support. Of the many studies that exist on the efficacy of care management interventions, only a handful espouse the benefits of “continuous healing relationships.”^3,4,5 Fewer studies, if any, explain the role of affect between care providers and patients in the healing process and how to achieve a …

Rural And Urban Medicine In Ecuador, Moira Black

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Free, Universal Health Care

• Health care is free to all workers and their children with support from the government, employers, and a portion of the workers’ paychecks.¹
• Military personnel do not contribute part of their paychecks to paying for healthcare.¹

Experiences With Prenatal Care Among Women In A Philadelphia Homeless Shelter, Stephanie Rand, Ms4, Montida Fleming, Ms3, Maria Somohod, Ms3, Caitlin Callaghan, Ms2, Alexandra Strauss, Ms2, Natalie Ziegler, Ms2, Anita Modi, Ms4, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

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Prenatal care for the underserved is a national concern, with pregnancy rates as high as 22% in homeless women and 75% of these women reporting barriers to care during pregnancy. Inadequate prenatal care confers increased risk for gestational complications and unfavorable postnatal outcomes, including prematurity and low birth weight. Yet while many studies delineate the prevalence and health consequences of inconsistent prenatal care in the homeless population, few address healthcare barriers. To both fill this gap in the literature and design effective interventions increasing consistency of care, we explored prenatal care experiences of pregnant homeless women at Philadelphia’s primary intake …

Health Needs Assessment For Head Start Children, Gerald Gibbons

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Background: Head Start Program

• Preschool program for low-income families, providing comprehensive learning and care for children ages birth through 5 years old.¹
• Receives federal funds through the Department of Health & Human Services. However, each Head Start program is a locally designed and implemented model based on local community needs and resources.¹
• One of many government requirements involves yearly health check-ups and up-to-date immunization records for all children enrolled.¹
• NSCA elicited services from Jefferson Center for Urban Health to investigate why some families have a difficult time completing the medical record requirements.

Crossmodal Encoding Of Motor Sequence Memories, Brittany Heckel, Marianne Stephan, Sunbin Song, Leonardo G. Cohen

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Background

• The field of motor rehabilitation is in need of more efficient and effective rehabilitation strategies.
• Each year, almost 2.5 million Americans suffer from traumatic brain injury (TBI) and roughly 800,000 Americans experience a stroke. ^{1, 2}
• The total annual direct and indirect costs of stroke and TBI in the United States are $65.5 billion and between $48 and $56 billion, respectively.^{3, 4}
• A promising new approach may lie in using sound as a neuromodulatory tool to access motor areas of the brain.
• Pianists, for example, can improve their performance of a previously practiced musical piece just by listening …

Comparison Of Breastfeeding Among White And African American Patients Delivering At Thomas Jefferson University Hospital, Rachel Horowitz, Theresa Burcher, Md, Abigail Wolf, Md, Rebecca J. Mercier Md Mph

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BACKGROUND

• Maternal breastfeeding has been widely accepted as the gold standard for infant nutrition during the first six months of life.¹
• Healthy People 2020 goals:

– 89.1% initiation of breastfeeding

– 60.6% breastfeeding for 6 months

– 32.4% breastfeeding for 1 year¹

• Global promotion of breastfeeding though Baby-Friendly Hospital Initiative

– Started by WHO and UNICEF in 1991 to assist hospitals in facilitating and promoting breastfeeding

– Provides education and skill building for all levels of staff

– Recognizes hospitals providing optimal care for infant nutrition²

• While the rates of breastfeeding have increased nationally since 1990, the …

Cervical Cancer In Guatemala: Using Visual Inspection With Acetic Acid Screening To Reduce Incidence Of And Mortality From Cervical Cancer, Zachary Klock

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Guatemala is a developing nation of nearly 16 million in Central America. Among the many health problems the nation suffers, cervical cancer remains a leading cause of cancer-related death. Cervical cancer, an easily detectable cancer, predominantly affects women in developing nations. Traditional cytology techniques have been used to screen women in the country for over 25 years, but less than 10% of the Guatemalan population is screened. The Visual Inspection with Acetic Acid (VIA) is a simple produce that uses acetic acid to visualize precancerous cervical lesions and has been proven to be more effective in resource-poor settings. The screening …

Alternative Income Generation For Kenyan Women: Preventing Prostitution And The Spread Of Hiv, Megan Elizabeth Lundy

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HIV/AIDS in Mlolongo, Kenya

Mombasa Highway and Weigh Station

• Truckers spend 3+ days waiting to be processed, providing a costumer base for prostitution
• In Kenya, 27.6% of female sex workers are HIV positive and only 26.8% use condoms with all of their partners (Morris, Morris, and Ferguson, 2009).
• The rampant spread of HIV and lack of contraception has led to rapid growth in the population in an area that has little ability to support any residents
• Development of Slums that now line the highway

Evaluating And Responding To Medical Student Demand For Global Health Education, Angela Ugorets, Bs, Maria Montano, Mph, Michael Cafarchio, Md, Daniel Becchi, Ba, Annie Masterson, Ba, Nithin Paul, Ba, Ellen Plumb, Md

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Introduction

With the constant interchange of people and diseases across continents, “the separation between domestic and international health problems is no longer useful.” (1) Look no further than the 80,000 refugees currently resettled in the United States for proof that health is a global phenomenon. The medical community needs to respond to the changing global landscape by training future healthcare leaders to think and act globally.

Medical students across the U.S. recognize this need with 68% of U.S. allopathic medical schools having an active student global or international health interest group. (2) Unfortunately, training opportunities lag behind student interest with …

Direct From The Students: Ideas To Improve Diversity Education At Sidney Kimmel Medical College, Elizabeth Sophy, Ms2, Christine Jerback, Md, Natasha Brown, Edd, Ms

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The Importance of Diversity

Diversity in medical education:

• Enhances students’ educational experience⁸
• Influences perspectives about culture, health, and about social issues³

Diversity in clinical practice:

• Decreases health disparities and improves outcomes³
• Increases patient satisfaction⁵
• Increases access for underserved^4,7

Hernia Surgery In Rural Ghana, West Africa: Barriers To Health Care And Their Implications, Laura Traub

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The information presented is a the product of a six week international rotation at Volta Regional Hospital and Royal Hospital through Blue-Med Africa, a non-governmental organization based out of Ho, Ghana. The goal of the rotation was to obtain an understanding of healthcare in Ghana and identify the differences between surgical procedures in West Africa and the U.S.

Growing A Sustainable Community, Joseph Fulginiti, Alexander Moxam, Roderick Thompson

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Poster includes: Summer Goals, Community Barriers, Fruits of Labor, Room for Growth and Community Assets.

Chronic Malnutrition In Guatemala, Nicholas Bishop, Susan Mcilvaine

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Poster includes:

• What is chronic malnutrition and what causes it?
• Why address malnutrition?
• Addressing the problem

Role Of Traditional Chinese Medicine In Modern Healthcare, Gealina Dun

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Theories of Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM), a form of complementary and alternative medicine (CAM), has been practiced for over 2500 years, and approaches health as an interrelated and holistic state of being. Using multiple methods, the theories of TCM aim to balance:

• Qi
• Yin and Yang (Fig. 1)
• The Five Elements
• ZangFu Organs

Women’S Perspective: The Underlying Factors Leading To Malnutrition In Poor Women In India, Tanuja Devaraj

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AIM

A qualitative pilot study aimed to understand the socioeconomic aspects leading to malnutrition in urban poor women in Bangalore, India.