Medicine and Health Sciences Commons^™

Upcoming Faculty And Staff Development Programs

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

Upcoming Faculty and Staff Development Programs including: Manuscript Writing Workshop, Interprofessional Education and Care Practicum, Faculty Recruitment for the Health Mentors Program, Register today for JCIPE’s 2012 Conference, Interprofessional Education Collaborative (IPEC) 2012 Institute, Ehpic 2012—Educating Health Professionals in Interprofessional Care, Collaborative Change Leadership: A Certificate Program for Healthcare & Health Education Leaders and All Together Better Health VI.

In The News

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

In the news including: APTR/Healthy People 2020 and Collaborating Across Borders (CAB III).

Exploring And Evaluating Interprofessional Training: A Brief Overview, Barret Michalec, Phd

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

This paper provides a general overview of an upcoming

evaluation plan with JCIPE that began this fall. This plan was

constructed primarily because although numerous training

institutions have constructed and implemented various courses

and programs designed to provide students with extensive

learning opportunities steeped in interprofessional education

(IPE)1-3, projects employing longitudinal and/or mixed-methods

approaches to understanding the multi-faceted barriers to and

facilitators of IPE within health professions training have been

quite limited. Similarly, few evaluation plans have attempted to

unearth if and how students are exposed to interprofessional

values outside of IPE-specific programs or how these team-based

values may translate …

Team Training Obstetrical Simulation Drills To Improve Perinatal Outcomes, Deborah A. Cruz, Msn, Rnc, Crnp, Carol Carofiglio, Phd, Msn

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

Sixteen year-old, timid Noelle arrived on the labor floor with complaints of severe abdominal pain and headache, onset earlier today at school. During her intake, she confided to her nurse that she is probably about 7 months pregnant with no prenatal care. Only her boyfriend knew. Her parents were oblivious. Noelle was petrified to tell her mother of the pregnancy. Mom arrived on the labor floor about thirty minutes later and was shocked to discover her daughter’s condition. The physician explained the situation to Mom. Noelle was 30 weeks pregnant, hypertensive with seizures. Mom could barely comprehend her daughter’s illness, …

Interprofessional Education In A Department Of Urology, Maryann Sonzogni

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

Optimum health care delivery requires increasing reliance allied health care professionals who are members of highly functioning teams. However, few allied health care professionals are trained in the specific field of urology. Within our urology department, care of patients is fragmented into different segments with little to no crossover of staff. Patient care may benefit from specialty training and additional education sessions for those involved in patient care. Interprofessional Education (IPE) offers a potential way to improve collaboration and may enhance healthcare outcomes.

From The Editors, Christine A. Arenson, Md, Elizabeth Speakman, Edd, Rn, Cde, Anef

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

Welcome to the latest edition of the JCIPE Interprofessional Education and Care Newsletter! Since our last edition, we have had some changes at JCIPE. First, founding Co-Director Dr. Molly Rose has begun a phased retirement and stepped down from her JCIPE position. Although parting is always bittersweet, we are thrilled that Molly is continuing to champion interprofessional education from her position in the Jefferson School of Nursing (JSN), and also still serving as chair of our Evaluation Workgroup. At the same time, transitions bring us the joy of new partners – and we are delighted to introduce Elizabeth Speakman, EdD, …

John Blair Deaver, M.D., And His Marvelous Retractor., Timothy E. Newhook, Md, Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

John Blair Deaver was born near Buck, Pennsylvania, in Lancaster County on July 25, 1855, to Dr. Joshua Montgomery Deaver and Elizabeth Clair Moore. The elder Deaver was a reputable country physician, educated at the University of Maryland, who fathered three physicians and a college president. John Blair Deaver (Fig. 1) went to boarding school at West Nottingham Academy in Maryland. After boarding school he taught in Lancaster County country schools to raise funds to attend the nation’s first medical school, the University of Pennsylvania. On receiving his M.D. degree in 1878, Dr. Deaver completed 1-year internships at both Germantown …

The Value Proposition Of Molecular Medicine., Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Individualized patient management is rapidly evolving, driven by the emergence of insights in discovery, development, regulatory, and comparative effectiveness sciences.^1-4 The pace of discovery is accelerating, enabled by platforms, including “omics”, stem cell biology, network medicine, and medical and biological informatics that provide unanticipated insights into pathophysiology.^{2, 4-6} The integration of these paradigms has established a model for identifying the mechanistic underpinnings of disease, offering novel opportunities to individualize diagnostics that shape how modern therapies are deployed, including markers of disease prognosis, clinical predictors of therapeutic responses, and molecular determinants that optimize clinical management.^7-10 Importantly, deconvolution of …

Association Between Triptanuse And Cardiac Contraindications In An Insured Migraine Population, Daisy Ng-Mak, Phd, Valerie P. Pracilio, Mph, Stephen Silberstein, Md, Joseph Couto, Pharmd, Mba, Cary Sennett, Md, Phd, Mary Hopkins, Rn, Jon Bumbaugh, Neil I. Goldfarb

College of Population Health Lectures, Presentations, Workshops

Background

Safety concerns exist when using triptansto treat patients with cardiac contraindications.

–Triptans cause vasoconstriction, a safety concern for migraineurswith cardiovascular (CV) disease or other cardiac risk factors.

–All triptans contain contraindications in their package inserts to avoid use in patients with cardiac conditions.

•Previous research indicates that clinicians are less likely to prescribe triptansin patients with CV disease or CV risk factors.

Limited research has examined the proportion of migraine patients with cardiovascular disease or those individuals who were concurrently treated with triptans.

Tropical Medicine Training In The Department Of Defense, Rodney L. Coldren, David Brett-Major, Patrick W. Hickey, Eric Garges, Peter J. Weina, Paula Corrigan, Gerald Quinnan

Journal Articles: Epidemiology

No abstract provided.

Annual Report To The Nation On The Status Of Cancer, 1975-2008, Featuring Cancers Associated With Excess Weight And Lack Of Sufficient Physical Activity, Christie Eheman, S. Jane Henley, Rachel Ballard-Barbash, Eric J. Jacobs, Maria J. Schymura, Anne-Michelle Noone, Liping Pan, Robert N. Anderson, Janet E. Fulton, Betsy A. Kohler, Ahmedin Jemal, Elizabeth Ward, Marcus Plescia, Lynn A. G. Ries, Brenda K. Edwards

United States Public Health Resources

BACKGROUND: Annual updates on cancer occurrence and trends in the United States are provided through collaboration between the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This year’s report highlights the increased cancer risk associated with excess weight (overweight or obesity) and lack of sufficient physical activity (<150 minutes of physical activity per week).

METHODS: Data on cancer incidence were obtained from the CDC, NCI, and NAACCR; data on cancer deaths were obtained from the CDC’s National Center for Health Statistics. Annual percent changes in …

James Marion Sims, M.D., Ll.D., Jonathan Tavares, B.S., Charles J. Yeo, Md, Pinckney J. Maxwell, Iv, Md

Department of Surgery Gibbon Society Historical Profiles

Few physicians have been as celebrated and loathed as James Marion Sims, M.D., LL.D. Dr. Sims’ modest early life and education never could have predicted that he would one day be called the ‘‘Father of American Gynecology.’’1, 2 Lauded by contemporaries and early historians as ‘‘one of the most original and gifted of American surgeons,’’ he performed the first successful operation to correct vesicovaginal fistulas (a condition that prior to 1852 was known as the ‘‘stumbling-block of gynecology’’).1 Today, the same work that earned Dr. Sims fame, fortune, and innumerable honors has been called into question, because of the unethical …

Manifestations Of Rheumatoid Arthritis: Epidural Pannus And Atlantoaxial Subluxation Resulting In Basilar Invagination., Adam L Schreiber, Do, Ma

Department of Rehabilitation Medicine Faculty Papers

Presented in part at the AAPMR 71st Annual Assembly Meeting, Seattle, WA, November 4-7, 2010.

Atlantoaxial instability results from cartilaginous destruction, periarticular erosions, and ligament and tendon attenuation. Instability affects 19%-70% of patients, and basilar invagination from vertical odontoid subluxation through the foramen magnum occurs in 38% of patients. This phenomenon occurs twice as often in women than men, whose age at diagnosis typically ranges from 30-50 years. Along with bony compression, the pannus further decreases the space available for the cord by 3mmor more in approximately 66% of patients (Figures 1-7). The earliest and most common symptom of cervical …

A Retrospective Analysis Of Sustainability: Chcs That Were Part Of A Consortia When Federal Funding Ended, Latonya B. Dunlow

MUSC Theses and Dissertations

Community health centers (CHCs) serve an important role in addressing gaps in access to care experienced by millions of Americans. There have been programs in the past developed to provide funding support to increase access to care. However, when funding ends some grantees are faced with program sustainability challenges. This study sought to identify factors and advice for sustainability of programs and services once funding ends. The findings of this study are consistent with the literature; however there were two qualities of leadership important to sustainability that were not as pronounced in the literature that were found in this study-perseverance …

Symptom Intrusiveness, Chronic Conditions And Health-Related Quality Of Life: Development Of Conceptual And Measurement Models, Jill Marie Monfre

MUSC Theses and Dissertations

Background: The number of patients in the United States living with chronic conditions is increasing as patients are surviving conditions that were previously fatal. This increase in survival has resulted in a shift in the disease burden in the United States from infectious to chronic diseases. Many patients with chronic conditions experience associated symptoms that impact their health-related quality of life more significantly than those without associated symptoms. To enable patients to achieve what they determine to be an acceptable state of wellbeing, health care providers must first be aware of the factors and the relationships among the factors that …

Developing A Pricing Strategy For The Los Angeles Dodgers, Denise Linda Parris, Joris Drayer, Stephen L. Shapiro

Human Movement Studies & Special Education Faculty Publications

In 2011, the Los Angeles Dodgers Stadium averaged 36,236 fans per game, dropping from 43,979 in 2010 and 46,440 in 2009, an overall loss of about 10,000 fans per game in just two years. In 2011, The Dodgers' attendance ranking fell from first to eleventh in Major League Baseball (MLB), which amounted to a loss of over 800,000 tickets sold per year, as well as the resulting revenue from concessions and parking. Despite the Dodgers' long and storied history, ticket demand had been negatively influenced by inconsistent performance, mounting bad publicity surrounding owner Frank McCourt's divorce, the beating of a …

Epidemiology Of Contemporary Seroincident Hiv Infection In The Navy And Marine Corps, David Brett-Major, Shilpa Hakre, Neal A. Naito, Adam Armstrong, Eric A. Bower, Nelson L. Michael, Paul T. Scott

Journal Articles: Epidemiology

Human Immunodeficiency Virus (HIV) infection continues at a steady rate among U.S. Sailors and Marines. This study provides the first service-specific description of HIV infection demographics. All Sailors and Marines identified as HIV infected between January 2005 and August 2010 were included. The project compared personnel and epidemiologic data, and tested reposed sera in the Department of Defense Serum Repository. This group comprised 410 Sailors and 86 Marines, predominantly men. HIV infected Marines were more likely to be foreign born than their Navy counterparts, 42% versus 10%, p < 0.001. Approximately half of the patients had deployed including to the wars in Iraq or Afghanistan. Nearly half of each group was infected by the age of 25. Similar to the U.S. epidemic, Black race was over-represented. Unlike national rates, Hispanic Sailors and Marines were not over-represented. Demographics were distinct for those of specific occupational specialties. Certain ship classes carried lower incidences. Clustering of HIV infection risk occurred around deployment. The Navy and Marine Corps have different patterns of HIV infection, which may merit distinct approaches to prevention. The Navy may have unique targets for prevention efforts to include pipeline training and first assignment as well as particular occupational environments.

Rehabilitation Utilization And The Marginal Cost Of Ischemic Stroke In South Carolina, Ann-Catherin Simpson

MUSC Theses and Dissertations

This study uses Medicare claims from 1997 and 2004 to examine two important health policy issues using patients with ischemic stroke as an example. We explore the differences in rehabilitation services utilization and expenditures for stroke prior to and after outpatient rehabilitation caps were enacted. We then examine the effect of using a total cost approach versus a marginal cost method to estimate the first year cost of stroke and stroke rehabilitation. We found the cap did constrain outpatient rehabilitation utilization and cost of rehabilitation services if examined only using Medicare Part B provider costs, but not when facility costs …

Re-Envisioning Nurse Faculty Mentoring: Developmental Network Connections That Count, Margaret Babb Kennedy

MUSC Theses and Dissertations

Fears surrounding the nurse faculty shortage in the United States have prompted significant emphasis on supporting novice educators and those in transition to new roles within academia through mentoring. Yet a continued focus on traditionally held notions of a hierarchical dyad limits possibilities for facilitating rich, diverse, mentoring relationships. A novel theoretical framework incorporating social network perspective is used to conceptualize the dynamic, multilevel reality of mentoring in examination of nurse faculty mentoring. This dissertation presents the results of an integrative review and qualitative study that explore evidence and experiences of nurse faculty mentoring using the unique developmental network lens, …

A Study Of The Management Of Opioid Prescriptions Among Patients With A History Of Substance Abuse, Kara G. Veeder

MUSC Theses and Dissertations

Prescription opioid abuse is the fastest-growing drug problem in the United States and has been declared an epidemic by the U.S. White House Office of National Drug Control Policy. Immediate release (IR) opioids, especially hydrocodone and oxycodone, are abused or misused most commonly. Dentists are only second to family physicians in the number of IR opioid prescriptions written. Just under ten percent of the population in the United States in 2010 were classified with substance dependence or abuse in 2009. This study poses the following questions: 1. Do patients with a personal or family history of substance abuse manage prescription …

Treating Mentoring Programs As A Scholarly Endeavor, Shane P. Desselle

Faculty Publications & Research of the TUC College of Pharmacy

The author discusses mentoring programs for pharmacy school faculty and the research literature around forming these programs.

A Systematic Review Of Physical Activity Interventions In Hispanic Adults, Melinda J. Ickes, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Healthy People 2020 aims to achieve health equity, eliminate disparities, and improve the health of all groups. Regular physical activity (PA) improves overall health and fitness and has the capability to reduce risk for chronic diseases. Identifying barriers which relate to the Hispanic population is important when designing PA interventions. Therefore, the purpose was to review existing PA interventions targeting Hispanic adults published between 1988 and 2011. This paper was limited to interventions which included more than 35% Hispanic adults (n = 20). Most of the interventions were community based (n = 16), although clinical, family-based, and faith-based …

Conversion From Enzyme-Inducing Antiepileptic Drugs To Topiramate: Effects On Lipids And C-Reactive Protein., Scott Mintzer, Christopher T Skidmore, Sara J Rankin, Inna Chervoneva, Edward Pequinot, David M Capuzzi, Michael R Sperling

Department of Neurology Faculty Papers

PURPOSE: We previously demonstrated that converting patients from the enzyme-inducers phenytoin or carbamazepine to the non-inducers levetiracetam or lamotrigine reduces serum lipids and C-reactive protein (CRP). We sought to determine if the same changes would occur when patients were switched to topiramate, which has shown some evidence of enzyme induction at high doses. We also examined the effects of drug switch on low-density lipoprotein (LDL) particle concentration.

METHODS: We converted 13 patients from phenytoin or carbamazepine monotherapy to topiramate monotherapy (most at doses of 100-150 mg/day). Fasting lipids, including LDL particle concentration, and CRP were obtained before and ≥6 weeks …

Trends In The Utilization Of Outpatient Advanced Imaging After The Deficit Reduction Act., David C Levin, Vijay M Rao, Laurence Parker

Department of Radiology Faculty Papers

PURPOSE: After the Deficit Reduction Act (DRA) took effect in 2007, there was concern that private office-based imaging facilities would close, that advanced imaging would shift to less convenient hospital-based facilities, and that access to advanced imaging might be restricted. The aim of this study was to see if these developments occurred during the years after the DRA.

METHODS: Using Medicare data, outpatient CT, MRI, and nuclear medicine trends before and after the DRA were studied. Procedure volumes performed in private offices and hospital outpatient departments (HOPDs) were tabulated separately. Volumes were tracked from 2000 to 2006 (before the DRA) …

Jefferson Alumni Bulletin – Volume 61, Number 1, Winter 2012

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

Features:

• The Gift of Time for Patients with Advanced Bile Duct Cancer
• Celiac Disease: Overcoming a Stealth Public Health Menace
• Light Therapy for a Blue Planet and Beyond

Association Between Hospitals Caring For A Disproportionately High Percentage Of Minority Trauma Patients And Increased Mortality: A Nationwide Analysis Of 434 Hospitals., Adil H. Haider, Sharon Ong'uti, David T. Efron, Tolulope A. Oyetunji, Marie L. Crandall, Valerie K. Scott, Elliott R. Haut, Eric B. Schneider, Neil R. Powe, Lisa A. Cooper, Edward E. Cornwell

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To determine whether there is an increased odds of mortality among trauma patients treated at hospitals with higher proportions of minority patients (ie, black and Hispanic patients combined).

DESIGN: Hospitals were categorized on the basis of the percentage of minority patients admitted with trauma. The adjusted odds of in-hospital mortality were compared between hospitals with less than 25% of patients who were minorities (the reference group) and hospitals with 25% to 50% of patients who were minorities and hospitals with more than 50% of patients who were minorities. Multivariate logistic regression (with generalized linear modeling and a cluster-correlated robust …

Eae/Ase Recommendations For Image Acquisition And Display Using Three-Dimensional Echocardiography., Roberto M. Lang, Luigi P. Badano, Wendy Tsang, David H. Adams, Eustachio Agricola, Thomas Buck, Francesco F. Faletra, Andreas Franke, Judy Hung, Leopoldo Pérez De Isla, Otto Kamp, Jaroslaw D. Kasprzak, Patrizio Lancellotti, Thomas H. Marwick, Marti L. Mcculloch, Mark J. Monaghan, Petros Nihoyannopoulos, Natesa G. Pandian, Patricia A. Pellikka, Mauro Pepi, David A. Roberson, Stanton K. Shernan, Girish S. Shirali, Lissa Sugeng, Folkert J. Ten Cate, Mani A. Vannan, Jose Luis Zamorano, William A. Zoghbi, American Society Of Echocardiography, European Association Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Lymph Node Ratio Is An Important And Independent Prognostic Factor For Patients With Stage Iii Melanoma., Adam C. Berger, Michael Fierro, John C Kairys, David Berd, Takami Sato, Jocelyn Andrel, Terry Hyslop, Michael J Mastrangelo

Department of Surgery Faculty Papers

INTRODUCTION: The incidence of melanoma is dramatically increasing worldwide. We hypothesized that the ratio of metastatic to examined lymph node ratio (LNR) would be the most important prognostic factor for stage III patients.

METHODS: We retrospectively reviewed our institutional database of melanoma patients and identified 168 patients who underwent lymph node dissection (LND) for stage III disease between 1993 and 2007. Patients were divided into three groups based on LNR (≤10%, n = 93; 10-≤25%, n = 45; and >25%, n = 30). Univariate and multivariate analysis was performed using Cox proportional hazards model.

RESULTS: The median survival time of …

Eae/Ase Recommendations For Image Acquisition And Display Using Three-Dimensional Echocardiography., Roberto M. Lang, Luigi P. Badano, Wendy Tsang, David H. Adams, Eustachio Agricola, Thomas Buck, Francesco F. Faletra, Andreas Franke, Judy Hung, Leopoldo Pérez De Isla, Otto Kamp, Jaroslaw D. Kasprzak, Patrizio Lancellotti, Thomas H. Marwick, Marti L. Mcculloch, Mark J. Monaghan, Petros Nihoyannopoulos, Natesa G. Pandian, Patricia A. Pellikka, Mauro Pepi, David A. Roberson, Stanton K. Shernan, Girish S. Shirali, Lissa Sugeng, Folkert J. Ten Cate, Mani A. Vannan, Jose Luis Zamorano, William A. Zoghbi, American Society Of Echocardiography, European Association Of Echocardiography

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Mutant Tdp-43 In Motor Neurons Promotes The Onset And Progression Of Als In Rats, Cao Huang, Jianbin Tong, Fangfang Bi, Hongxia Zhou, Xu-Gang Xia

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Amyotrophic lateral sclerosis (ALS) is characterized by progressive motor neuron degeneration, which ultimately leads to paralysis and death. Mutation of TAR DNA binding protein 43 (TDP-43) has been linked to the development of an inherited form of ALS. Existing TDP-43 transgenic animals develop a limited loss of motor neurons and therefore do not faithfully reproduce the core phenotype of ALS. Here, we report the creation of multiple lines of transgenic rats in which expression of ALS-associated mutant human TDP-43 is restricted to either motor neurons or other types of neurons and skeletal muscle and can be switched on and off. …