Medicine and Health Sciences Commons^™

Jeffhope News-Fall 2015

JeffHOPE News

Issue includes:

• HIV Rapid Testing
• Clinic at a Glance
• JeffHope Research Projects
• Questions and Answers with Dr. Dave Manoff and Dr. Tori Rose
• The Directors and Committee members reflect on their JeffHOPE experiences
• How would you describe JeffHOPE in one word?
• Alumni Corner

Chimeric Cells Of Maternal Origin Do Not Appear To Be Pathogenic In The Juvenile Idiopathic Inflammatory Myopathies Or Muscular Dystrophy., Carol M Artlett, Sihem Sassi-Gaha, Ronald C Ramos, Frederick W Miller, Lisa G Rider

Department of Medicine Faculty Papers

INTRODUCTION: Microchimeric cells have been studied for over a decade, with conflicting reports on their presence and role in autoimmune and other inflammatory diseases. To determine whether microchimeric cells were pathogenic or mediating tissue repair in inflammatory myopathies, we phenotyped and quantified microchimeric cells in juvenile idiopathic inflammatory myopathies (JIIM), muscular dystrophy (MD), and noninflammatory control muscle tissues.

METHOD: Fluorescence immunophenotyping for infiltrating cells with sequential fluorescence in situ hybridization was performed on muscle biopsies from ten patients with JIIM, nine with MD and ten controls.

RESULTS: Microchimeric cells were significantly increased in MD muscle (0.079 ± 0.024 microchimeric cells/mm(2) …

The Generation Of Transformation, Stephen Klasko Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Using Interprofessional Education & Simulation-Based Learning In Health Profession Curricula To Improve Competence & Confidence: A Systematic Review, Danielle Elfand, Ots, Briana Elson, Ots, Courtney Hudson, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

● Describe the types of interprofessional education (IPE) simulation-based learning experiences in current health professions curricula.

● Discuss benefits for implementation of IP simulation into pre-licensure health profession programs.

● Explain how IP simulation-based learning improves workforce competency and confidence in entry-level health

● professionals.

PICO: What is the impact of interprofessional education simulation activities in improving workforce competency and confidence in entry level health professionals?

Presentation: 44 minutes

I Think Therefore I Can. A Systematic Review Of Metacognitive Strategies And Their Impact On Occupational Performance In Adults Following Stroke, Kerry Canton, Ots, Chelsea Difrancesco, Ots, Christy Geaney, Ots, Sarah Jamieson, Ots, Jessica Talarico, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

1. Explain the role of metacognition in everyday activities

2. Discern the quality of evidence regarding metacognitive strategies in adults who have sustained a stroke.

3. Conceptualize a metacognitive intervention to utilize within stroke rehabilitation based on the evidence

presented in this session.

PICO: What is the evidence for the impact of metacognitive interventions on occupational performance in adults who have sustained a stroke?

Presentation: 43 minutes

Reach For The Stars: Improving Upper Extremity Function After Spinal Cord Injury, Carlisle Bland, Ots, Molly Bucciero, Ots, Shelby Hankins, Ots, Blair Krevitz, Ots, Nicole Matyas, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

1.) Describe how cervical spinal cord injury affects UE functioning necessary for activities of daily living.

2.) Describe occupational therapy interventions used to increase UE functioning in cervical SCI.

3.) Discuss how current evidence supports implementing occupational therapy interventions into clinical practice for individuals with cervical SCI, in order to maximize independence in activities of daily living.

PICO: What is the evidence supporting occupational therapy interventions to increase upper extremity function in order to improve ADL performance following Cervical Spinal Cord Injury?

Presentation: 42 minutes

Promoting Quality Of Life For Individuals With Huntington’S Disease, Lyndsay Gentile, Ots, Mallory Koch, Ots, Elyse Mccabe, Ots, Jessica Royal, Ots, Sarah Sadofsky, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

 Describe the symptoms of Huntington’s disease and their impact on functional performance.

 Recognize the role of occupational therapy in improving quality of life for individuals with Huntington’s disease.

 Discuss how occupational therapy interventions for individuals with Huntington’s disease can be applied in a variety of settings.

Clinical Question:

What is the effectiveness of occupational therapy interventions in improving quality of life for individuals with Huntington’s disease?

Presentation: 46 minutes

Early Mobilization In The Intensive Care Unit (Icu): A Systematic Review, Lara Belasco, Ots, Shannon Dixon, Ots, Nina Pesce, Ots, Jennifer Wong, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Learning Objectives:

At the conclusion of the session, the learner will be able to:

1. Explain early mobilization techniques in the Intensive Care Unit (ICU)

2. Identify the role of occupational therapy in the ICU

3. Discuss the implications of early mobilization interventions for adults in the ICU

Clinical Question:

What are the effects of early mobilization on ADL performance for adults in the ICU?

Presentation: 42 minutes

A World Of Opportunities: Community Reintegration For Individuals With Brain Injury, Francine Gebbia, Ots, Amy Miller, Ots, Marianella Sanchez, Ots, Erica Serviolo, Ots, David Turoff, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

● Define community reintegration within the scope of occupational therapy

● Explain the importance of community reintegration for adults with a brain injury

● Discuss the effectiveness of occupational therapy interventions used to promote community reintegration

for adults with a brain injury

PICO:

What is the effectiveness of occupational therapy interventions in community reintegration for individuals with brain injury?

Presentation: 53 minutes

Back In The Saddle: A Systematic Review Of Occupational Therapy Interventions That Facilitate Return-To-Work, Preston W. Lockwood, Ots, Julie Luu, Ots, Brady Mcguire, Ots, Jay Skaria, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

1. Recognize the opportunity for injured workers, organizations, and society to benefit from occupational therapy interventions that improve return to work (RTW) outcomes.

2. Classify RTW occupational therapy interventions based on effectiveness.

3. Describe strategies to apply evidence-based interventions in current clinical practice.

PICO: What interventions within the scope of occupational therapy best facilitate return-to-work for adults with musculoskeletal disorders on workers compensation?

Presentation: 50 minutes

Interventions For Improving Occupational Performance Post-Concussion In Children And Adolescents: A Scoping Review, Abigail Gilmore, Ots, Amy Gottesman, Ots, Sarah Kauper, Ots, Michelle Malon, Ots, Brianna Schwoyer, Ots, Alisha Unternahrer, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives of Presentation:

● Recognize the significant impact of concussion on immediate and long-term mental and physical well being in the pediatric population.

● Identify the need for novel and effective interventions that address the impact of pediatric concussions.

● Describe current concussion interventions and management practices and the gap that exists in the literature.

● Discuss interventions within the scope of OT practice to address occupational performance in children and adolescents post-concussion.

Clinical Question: What interventions within the scope of occupational therapy practice are indicated in the current literature to improve occupational performance in children and adolescents who have …

Jefferson Digital Commons Redesign, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

The Jefferson Digital Commons has a new look. The site includes a new banner and layout to help researchers navigate the site.

Skmc Student Handbook 2015-2016, Thomas Jefferson University

Jefferson Medical College Administrative Documents and Reports

71 page student handout

Predicting The Laterality Of Temporal Lobe Epilepsy From Pet, Mri, And Dti: A Multimodal Study., Dorian Pustina, Brian Avants, Michael R Sperling, Richard Gorniak, Xiaosong He, Gaelle Eve Doucet, Paul Barnett, Ms, Scott Mintzer, Ashwini Sharan Md, Joseph I Tracy

Department of Neurology Faculty Papers

Pre-surgical evaluation of patients with temporal lobe epilepsy (TLE) relies on information obtained from multiple neuroimaging modalities. The relationship between modalities and their combined power in predicting the seizure focus is currently unknown. We investigated asymmetries from three different modalities, PET (glucose metabolism), MRI (cortical thickness), and diffusion tensor imaging (DTI; white matter anisotropy) in 28 left and 30 right TLE patients (LTLE and RTLE). Stepwise logistic regression models were built from each modality separately and from all three combined, while bootstrapped methods and split-sample validation verified the robustness of predictions. Among all multimodal asymmetries, three PET asymmetries formed the …

The Effect Of Aspirin On Bleeding And Transfusion In Contemporary Cardiac Surgery., Jordan E Goldhammer, Gregary D. Marhefka, Constantine Daskalakis, Mark W Berguson, John E Bowen, James Diehl, Jianzhong Sun

Department of Medicine Faculty Papers

OBJECTIVE: Despite evidence that preoperative aspirin improves outcomes in cardiac surgery, recommendations for aspirin use are inconsistent due to aspirin's anti-platelet effect and concern for bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on bleeding and transfusion in cardiac surgery.

METHODS: This retrospective study involved consecutive patients (n=1571) who underwent CABG, valve, or combined CABG and valve surgery at a single center between March 2007 and July 2012. Of all patients, 728 met the inclusion criteria and were divided into two groups: those using (n=603) or not using (n=125) aspirin within 5 days …

Jdc Editor A 2015 Ir All-Star, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

JDC Editor Dan Kipnis has been recognized as a “2015 IR All-Star” in the DC Telegraph, a blog of the bepress Digital Commons community, for his outstanding promotion of the Jefferson Digital Commons. The JDC is Thomas Jefferson University’s institutional repository designed to enhance the visibility of Jefferson scholarship and to promote Jefferson authors. With more than 10,000 assets to date, the JDC recently exceeded 2 million downloads.

From The Editors, Harkirat Singh, Md, Michael A. Valentino, Md, Phd

The Medicine Forum

We are proud to publish the 15th issue of The Medicine Forum. Since its inception, this journal has provided a medium for medical students and housestaff to share their scholarly pursuits and clinical experiences with the Jefferson community. It has served as a platform both for those pursuing careers in academic medicine as well as those wishing to share their personal experiences with a larger audience. This year we are introducing a new section called Clinical Images which will showcase interesting physical exam findings and radiographic images accompanied by brief patient vignettes. We have been fortunate to have received numerous …

Table Of Contents

The Medicine Forum

Table of Contents for The Medicine Forum, Volume 16, 2014-2015.

From The Editors, Anusha G. Govind, Md, Loheetha Ragupathi, Md, Michael A. Valentino, Md, Phd

The Medicine Forum

We are excited to present you with the 16th annual edition of The Medicine Forum. This work is a culmination of months of effort on the part of medical students, residents, fellows and faculty to share clinical pearls from the last year of their experiences.

Amongst the greatest strengths of medical professionals and patients alike is the ability to tell stories. Stories, and how they are told form the basis of medical care. The way in which a particular patient's story unfolds has a lasting impact on physicians, trainees, other medical staff, and perhaps most importantly, on future patients. Stories …

Jefferson Digital Commons Quarterly Report: April-June 2015, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi

Jefferson Digital Commons Reports

This quarterly report includes:

• 10,000th Asset
• Pennsylvania Research Commons
• Faculty Day presentations
• Variety of new assets in the JDC
• Inside Out literary journal
• What people are saying about the JDC

Kinase Independent Oncogenic Cyclin D1., Mathew C Casimiro, Andrew Arnold, Richard Pestell

Kimmel Cancer Center Faculty Papers

No abstract provided.

Whole Person Orientation In Primary Care: Understanding Priorities And Assessing Performance, Shannon Doyle

Master of Public Health Capstone Presentations

The purpose of this project was to use a participatory research methodology to develop a framework for understanding the concept of whole person orientation in primary care delivery. Whole person orientation is one of the seven Joint Principles of the Patient Centered Medical Home (PCMH) authored by the American Academy of Family Physicians in partnership with several other physician organizations. Although the PCMH model of primary care has been touted as part of the solution to the U.S. healthcare system’s cost and quality issues, there are few tools available to evaluate implementation of the essential components and none at all …

Low-Income African American Women's Perceptions Of Primary Care Physician Weight Loss Counseling: A Positive Deviance Study, Elaine Seaton Banerjee, Md

Master of Public Health Capstone Presentations

The purpose of this study was to qualitatively and quantitatively evaluate the interactions between low-income, African American women who successfully lost weight and the healthcare system. This mixed methods study followed a positive deviance approach, identifying a population at high risk for obesity and then identifying positive deviants within this population. In this case, positive deviants were low-income, African American women who had been obese, and had successfully lost at least 10% of their weight and maintained this loss for at least six months. We collected data from electronic medical records (EMR) and participant surveys of both positive deviant cases, …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Spring 2015, Volume 6, Issue 1

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download entire issue- Jefferson Interprofessional Education and Care Newsletter, Spring 2015, Volume 6, Issue 1

Ipe Grand Rounds Learning Activity, Adrienne Christopher

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I attended the IPE Grand Rounds hosted by Jefferson Students for Interprofessional Education (JSIPE) with the Palliative Care Team. There were several different health care professionals present on the panel that explained their specific and individualized roles within the Palliative Care team, as well how these roles united to help them function best as a group. The panel demonstrated these specific roles with a case presentation that also helped illustrate some of the conflicts they face on a daily basis, and how they overcome these conflicts to best serve their patients.

Teamstepps® Interprofessional Learning Activity, Brady Mcguire

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In October 2014 I participated in a TeamSTEPPS® interprofessional (IP) learning activity that has already positively affected my performance in my first clinical field-work rotation. An IP team of professors from the nursing, occupational therapy, medicine, and pharmacy programs hosted the learning activity. Potential difficulty of cross-disciplinary interaction was noted from the beginning as students from each discipline sat in groups despite encouragement to split up. However, with direction from the professors, we formed small interdisciplinary groups and participated in a teamwork-focused icebreaker followed by a lecture about the origins and techniques of the TeamSTEPPS® system. After the lecture we …

Interprofessional Student Hotspotting Project, Mariana R. Kuperman, Mph, Brooke Salzman, Md, Mary Bonnet, David Goldstein, Anna Marie Morlino, Florda Priftanji, Jennifer Shoemake

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Background: IPE and Practice-based Learning

It is well established that there is a need for Interprofessional Education (IPE) in the current landscape of health education1 and students that participate in IPE enjoy these experiences and develop skills in interprofessional teamwork that prepare them for future team-based practice.2,3,4 IPE, however, is not standardized. It ranges from programs that teach theoretical frameworks in a classroom setting to others that allow interprofessional teams of students to work together in a clinical setting.5,6 The second form is referred to as practice-based learning (PrBL).3 PrBL is now considered by experts as one of the most …

Development Of A Cultural And Spiritual Toolbox: A High Impact Interprofessional Project, Marian Nowak, Dnp, Mph, Rn, Fcn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Healthcare providers may not be prepared to incorporate cultural and spiritual aspects of patient care within their practice. The cultural and spiritual toolbox project will increase the opportunity for those working in a local three campus hospital system to deliver patient-centered care at the bedside by helping them recognize the nuances of various cultures and religions. An interprofessional team convened over a one year period to explore how these aspects of care could be met.

To this end, the team researched and developed a “Cultural and Spiritual Toolbox” which offers information in an online format. This project will be fully …

From The Editors, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Lauren Collins, Md, Christine Arenson, Md, Shoshana Sicks, Edm

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

As the spring semester comes to a close, we in the Jefferson Center for InterProfessional Education (JCIPE) reflect on the last year. In the Fall 2014 edition of the Interprofessional Education and Care Newsletter, we presented several innovative IPE projects from students, faculty and our colleagues overseas. The articles in this edition build on that progress, high-lighting our efforts, redefined during a January 2015 Jefferson IPE retreat facilitated by Dr. Malcolm Cox, to more closely link IPE and clinical practice. To this end, the spring semester marked the conclusion of the first administration of our revised Jefferson Health Mentors Program …

Network-Based Stratification Analysis Of 13 Major Cancer Types Using Mutations In Panels Of Cancer Genes., Xue Zhong, Hushan Yang, Shuyang Zhao, Yu Shyr, Bingshan Li

Department of Medical Oncology Faculty Papers

BACKGROUND: Cancers are complex diseases with heterogeneous genetic causes and clinical outcomes. It is critical to classify patients into subtypes and associate the subtypes with clinical outcomes for better prognosis and treatment. Large-scale studies have comprehensively identified somatic mutations across multiple tumor types, providing rich datasets for classifying patients based on genomic mutations. One challenge associated with this task is that mutations are rarely shared across patients. Network-based stratification (NBS) approaches have been proposed to overcome this challenge and used to classify tumors based on exome-level mutations. In routine research and clinical applications, however, usually only a small panel of …