Medicine and Health Sciences Commons^™

Renewing Hearts: Catholic Perspectives In Valve Replacement Surgery For Those Who Use Intravenous Drugs, Kimberly Feeney, Robert Perkel, Md

Phase 1

Introduction: The incidence of infectious endocarditis has been increasing, particularly among those with a history of intravenous drug use (IVDU). Although current bioethics literature supports valve surgery as treatment for this patient population, clinical guidelines and literature continues to provide unclear recommendations for physicians. Catholic bioethics may provide a different perspective to re-contextualize the recommendations of secular ethics.

Methods: A PubMed search was used to gain background information regarding the incidence of infectious endocarditis and current treatment guidelines, as well as historical and current ethical considerations. Search terms included: “infectious endocarditis,” “IE,” “intravenous drug use,” “IVDU,” “ethics.” Related citations were …

Therapeutic Art For Individuals With Multiple Sclerosis, Alexandra Kocsik, Silva Markovic-Plese, Md, Phd

Phase 1

Introduction: Depression is more prevalent in individuals with MS than in the average population, which presents complications of quality of life beyond simply the primary disease process. This project aims to explore the immediate emotional benefits of therapeutic art sessions for individuals with MS, in addition to exploring the feasibility of reducing concomitant depression in this population with therapeutic art alongside standard medical therapy.

Methods: Therapeutic art sessions were held with 3 support groups of 5 to 12 individuals with MS. Participants were initially prompted with a writing exercise regarding how they perceive themselves, and then prompted to paint a …

Stop Requested: A Collection Of Als Poetry, Brittany File, Katherine Hubbard, Ma

Phase 1

Introduction: This project aims to use poetry to convey the lessons, challenges, and experiences encountered by patients in the Jefferson Weinberg ALS Center diagnosed with Amyotrophic Lateral Sclerosis (ALS). This will not only allow for individual patients to freely discuss, reminisce, and reflect on their journey with this disease, but distributing the collection to our community will aid in a better understanding of ALS patients, serve to humanize ALS, and deepen the empathic beyond between community members and patients. Additionally, it will create an environment in which both myself and physicians can reflect on the human experience and how disease …

Effect Of Sustained Attention On Early Start Denver Model Outcomes, Katherine Mcleod, Giacomo Vivanti, Phd

Phase 1

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes.

Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Peri Levey, Kyle Prochno, Prashant Rao, Md, David Shipon, Md, Facc, Facp, Jeremy Close, Md

Phase 1

Introduction: The strongest risk factor for primary hypertension in children is obesity, and concern for pediatric hypertension rises with the rising prevalence of obesity in American children. Specifically, in urban Philadelphia schools from 2009 to 2012, preparticipation physical evaluations (PPEs) demonstrated a positive correlation between blood pressure measurements demonstrating stage 1 or 2 hypertension and elevated body mass index (P < 0.00001).

Objective: The purpose was to identify potential differences in cardiovascular health and prevalence of obesity between adolescents in the urban and suburban Philadelphia areas.

Methods: Data from PPEs administered to urban Philadelphia high school athletes in 2018 by the Athlete …

Health Concerns In The Juvenile Justice System In Philadelphia: An Analysis, Sarah Humrich

Phase 1

Introduction: There are more than 40,000 minors nationwide that are incarcerated, and yet there remains to be no standardized way to offer this population health care. Time spent in prison offers a unique opportunity that could allow healthcare workers to intervene, providing needed health care to an otherwise neglected population. This research seeks to better understand the healthcare offered to youth in juvenile detention centers in Philadelphia and to determine the unique health concerns of this population.

Methods: The target population of this study is the incarcerated youth in the juvenile detention centers of Philadelphia. I intend to collect data …

Survey Of Hie Leaders: Assessment Of Hie Research Participation And Perceptions, Brittany Macdonald, Kristin Rising, Md, Ms

Phase 1

Introduction: Health information exchanges (HIEs) allow for healthcare providers to effectively and securely access patient information from various healthcare networks. Some HIEs have acknowledged the important role they can play in research, however, this is not standard practice despite recognition that availability of research and outcomes data is a main limitation to evidence-based practice.

Methods: We created an electronic survey in collaboration with Health Share Exchange (an HIE in Philadelphia) with the aim of assessing HIE leader perceptions regarding the importance of and barriers to participation in research. The survey was disseminated via a Strategic Health Information Exchange Collaborative (the …

Predictors Of Negative Outcomes And Causes Of Loss To Follow Up Among Breast Cancer Patients In Port-Au-Prince, Haiti, A. Johnson, R. R. Henderson, G. Jones, Y. Fujii, P. Haley, J. Bernard, V. Degennaro

Phase 1

Objective: To determine predictors of negative outcomes and causes of loss to follow-up (LTFU) in patients with breast cancer in Haiti.

Design and Methods: Patients seen by Innovating Health International’s (IHI) cancer program were designated as LTFU after at least six months of non-contact (n=606). A cohort of LTFU breast cancer patients (n=101) was compared to the larger population of breast cancer patients (n=939), and a regression model constructed in order to identify risks for death and LTFU. Multiple calls were made to contact LTFU patients, and reasons for LTFU were recorded.

Results: Death and LTFU status were associated with …

Veteran Employment: A Study Into Barriers In Healthcare Industry Positions, Javier Saldana, Debby Derricks

Phase 1

Introduction: While there are many challenges veterans face while making the transition to the civilian lifestyle, undoubtedly one of the more frustrating factors is finding employment. While the veteran unemployment rate has dropped in recent years, it currently sits at ~3.4%. Therefore, an estimated 323, 000 veterans are currently unemployed. Given these statistics, what are the common barriers veterans face when seeking employment, specifically in healthcare industry positions?

Methods: Two (30 minute) interviews will be conducted with individuals heavily involved in veteran employment at Jefferson Hospitals. The questions asked the interviewee’s opinions on factors that make veterans successful in gaining …

Quality Improvement Study Of Behavioral Health Resources Access In 19121 And 19132, Courtney Kaye, Rickie Brawer, Mph, Phd, Mches, Jeanne Felter, Phd, Lpc

Phase 1

Introduction: Children who have experienced four or more ACES (adverse childhood events) are shown to have negative mental health outcomes. Adolescents living in the Philadelphia zip codes 19121 and 19132 have higher ACE scores. This makes it necessary for adolescent providers to screen for behavioral health issues in their patients and refer out to appropriate resources.

Objective: The purpose of this quality improvement study is to see what current barriers exist relating to physician referral and access to behavioral health resources for their patients.

Methods: A guide of behavioral health resources available to adolescents in 19121 and 19132 was …

Development Of An Emergency Room Identification Tool To Aid In The Identification Of Victims Of Sex Trafficking, Misha Yakobi, Amy Leader

Phase 1

Despite the reality that the majority of victims of sex trafficking interact with the healthcare system, there is no uniformly implemented or agreed upon screening tool utilized by emergency departments to identify members of this population. In addition, there is no easily accessible composite of resources available to be distributed if these victims of sex trafficking are identified. This study aims to aid in the design and dissemination of such a screening tool and to create a composite of local and national resources that serve this population.

Using an interview guide, conversations were held with policy experts and healthcare professionals. …

The Effects Of Centering Pregnancy On Attitudes Towards Breastfeeding Among Women With Opioid Use Disorder, Francesca Mancuso, Vanessa Short, Phd, Mph

Phase 1

Introduction: Breastfeeding has been found to decrease severity of neonatal abstinence syndrome (NAS), however, breastfeeding rates among women with opioid use disorder (OUD) are significantly lower than national averages. CenteringPregnancy, a group prenatal care model, increases exposure to education regarding breastfeeding, making it more likely that patients breastfeed in traditional populations.

Objective: This project’s purpose was to identify and understand current infant feeding attitudes among mothers with OUD and explore whether participation in the CenteringPregnancy “Breastfeeding Session” positively impacted knowledge and attitudes towards breastfeeding.

Methods: Data were collected from 12 women in treatment for OUD who participated in CenteringPregnancy. A …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

Parks And Shootings In Philadelphia From 2005-2015: A Proximity Analysis, Crystal Lee, Mph, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Urban green space exposure has been negatively correlated with mortality, and positively correlated with mood, attention, and physical activity; however, the relationship between urban green space, violence, and crime is still a topic of contention. The Philadelphia Horticultural Society found significant reductions in gun assaults and gun robberies in greened lots vs. ungreened lots. It is unclear whether or not there is a protective effect of parks overall for shootings in Philadelphia.

Methods: In order to explore the relationship between green space and shootings in Philadelphia, we compiled data from 2005-2015 police reports to map out where shootings and …

Advocating For Protective Measures Against Childhood Lead-Poisoning In Philadelphia Rental Homes, Claire Miller, Colleen Mccauley

Phase 1

Introduction: Lead exposure has been linked to delays in development and behavioral problems in children. Over 1,500 children are poisoned by lead each year in Philadelphia; the majority (62%) in rental homes.

Objective: The purpose of this project was to understand the impact of lead poisoning on children in Philadelphia, the current policies in place to protect children and the ways in which various stakeholders can advocate for policy changes that will better protect children.

Methods: A mixed-methods approach was utilized including meetings with councilmembers, stakeholder interviews and data analysis, visualization and presentation. This information was used to gain councilmembers’ …

Constructing And Implementing A Summer Wellness Curriculum: Bridging The Gaps At Yes, Lauren Lynch, Julia Gong, Tim Massaquoi, Ma

Phase 1

Introduction: Youth experiencing homelessness lack learning experiences during the summer months, potentially leading to delinquent activities and hazardous situations. The project created and implemented a summer wellness curriculum at Youth Emergency Service (YES) that aimed to identify gaps in and educate the youth on various health and wellness topics. Daily exercise actively promoted physical wellbeing.

Methods: The curriculum aimed at a mixed group of adolescents facing homelessness integrated various educational and/or physical activities with wellness activities by YES staff and Title I programming. Activity description, cost, location, time and date, and number of attendees were recorded in a logbook. Qualitative …

Identifying The Health Needs Of The East North Philadelphia Latino Youth Via Photovoice, Vincent Pepe, Maria F. Arisi, John Mckeegan, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: The East North Philadelphia community contains the city’s largest Latino population, most of whom are of Puerto Rican and Dominican descent. This community in particular has unique health needs compared to the rest of the city of Philadelphia, with rates of diabetes (22.9%), asthma (28.6%), and poverty (45.5%) exceeding the national and city averages. Documenting the perceived needs of the children living here regarding their built environment will provide insight into the problems onto which the community at large needs to focus. This study aims to determine the priority needs of the community and to empower the youth …

Patient Engagement And Opinions Of A Medication Assisted Treatment Program For Opioid Use Disorder: A Qualitative Assessment, Sarah Wagoner, Lara Weinstein, Md

Phase 1

Introduction: Opioid use disorder is widely regarded as a national health epidemic. Stephen Klein Wellness Center 6as started a Medication-Assisted Treatment (MAT) program to help combat this epidemic- a program that is unique in that it does not require sustained abstinence for continued participation in the program.

Objective: The objective of this study is to better understand the beliefs and attitudes of patients towards a substance use treatment program that does not require sustained abstinence.

Methods: Five focus groups, totaling 31 participants, were assembled from patients who are current participants in Stephen Klein’s MAT program. The content of the interviews …

An Environmental Assessment Of Barriers To Hpv Vaccination In Lira, Uganda, Mary Ryan, Amy Leader, Phd

Phase 1

Introduction: Vaccination against HPV is a global concern, given that cervical cancer is the most common cancer among women in developing countries, such as Uganda. Uganda has launched a national program to vaccinate girls 9-13 with Gardasil^â for HPV prevention, yet areas like Lira in northern Uganda are well below the 80% coverage goal. While there is infrastructure at a national level to vaccinate girls against HPV, this project aimed to assess barriers to vaccination at a local level.

Methods: Semi-structured interviews with individuals in Lira, providers at Ayira Health Services, and a stakeholder at the Uganda Ministry of …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

Comorbidities And Treatments In United States Youth With Chronic Musculoskeletal Pain, Matthew T. Taylor, Sabrina Gmuca, Alexis Boneparth, L. Nandini Moorthy, Daniel B. Horton

Phase 1

Introduction: Chronic musculoskeletal (MSK) pain has been associated with chronic illnesses and high rates of pain medication use, often in referral centers, European populations, or studies focused on single drug classes. We aimed to characterize patterns of comorbidities and treatments associated with chronic MSK pain in a nationally-representative sample of US youth.

Methods: We used the National Ambulatory Medical Care Survey (2002-2015) and National Hospital Ambulatory Medical Care Survey (2002-2011), which contain cross-sectional data for US outpatient visits. The study included all visits for youth age 8-24, excluding those with malignancy or sickle cell disease. We compared comorbidities and drugs …

Housing First For People With Opioid Use Disorder (Oud) And Engagement With Medication-Assisted Treatment (Mat) And Harm Reduction Services, Husayn Siddiqui, Ashley Katzenstein, Lara Weinstein, Md, Drph

Phase 1

Intro: Opioid Use Disorder (OUD)is one of the most prevalent and deadly SUD’s in the country and many barriers exist for individuals living with homelessness and concurrent psychiatric illnesses when hoping to engage in Medication-Assisted-Recovery/Treatment (MAR/MAT). The current study evaluates the Pathways to Housing PA’s (PTHPA) Housing First(HF) model which provides scatter-site housing with social and maintenance services to individuals with a history of chronic homelessness and a diagnosis of OUD.

Methods: A retrospective chart analysis was completed for to assess factors relating to MAT engagement using PTHPA’s Credible BH recording system. MAT engagement prior to HF, psychiatric, homelessness, and …

Identifying The Health Needs Of Latino Youth In East North Philadelphia Through Photovoice, John Mckeegan, Maria Arisi, Vincent Pepe, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: The Hispanic population in East North Philadelphia is abounding with risk factors for poor health. These structural risk factors adversely affect the Hispanic adolescents in the area – a demographic that has historically had little say in the research that is done to contextualize the self identified health needs in the community.

Objective: The purpose for this project is to identify the factors that are both helping and preventing healthy development and living of Hispanic adolescents in East North Philadelphia, as well as beginning to find avenues of support for the prioritized self identified needs.

Methods: A Photovoice project …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Ilana Porges, Vaishali Mehta, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: Delays in management of high risk pregnancies can result in significant morbidity for women seeking obstetric care. A trend of high incidence of pregnancy complications has been observed among women with non-communicable diseases (NCDs) receiving care at the University Teaching Hospital of Kigali (CHUK), which may suggest the need for more consistent screening of NCDs among pregnant women, and more streamlined care for those identified to be at highest risk for complications.

Methods: This study utilized a mixed method design to assess the need for screening of NCDs among pregnant women (n=255) who received obstetric care at CHUK between …

A Report From The Grndad Multi-Site Registry For Sickle Cell Disease: Iron Overload Is Under-Recognized And Under-Managed, Matthew Sears, Phd, Sophie Lanzkron, Md, Mhs, Carolyn Hoope, Md, Joshua J. Field, Md, E. Leila Jerome Clay, Md, Mcts, Faap, Susan Padrino, Md, Payal C. Desai, Md, Lynne D. Neumayr, Deepa Manwani, Md, Jane Little, Md

Phase 1

Introduction: GRNDaD is a prospective registry for people with SCD that opened to enrollment in 2016. Nine comprehensive SCD centers from across the United States are currently enrolling patients. The registry includes iron status and management data, important in SCD because chronic transfusion therapy is a mainstay of prophylactic management. Each unit of transfused blood introduces approximately 250 mg of iron into the blood, which can lead to systemic iron deposition, and untreated may lead to organ dysfunction or death.

Methods: GRNDaD currently contains prospective baseline and annual update information on approximately 1000 people with SCD. We analyzed ferritin levels …

Obesity And Cardiovascular Health Differences Between Urban And Suburban Philadelphia High School Athletes, Kyle W. Prochno, Peri Levey, Prashant Rao, Md, David M. Shipon, Md, Facc, Facp, Jeremy D. Close, Md

Phase 1

Introduction: Limited data exist regarding hypertension and obesity levels of Philadelphia-area high school student-athletes. We aim to assess their prevalence in an urban population, investigate whether they are correlated with demographic factors, and determine whether urban student-athletes differ in these outcomes compared to their suburban/non-urban counterparts.

Methods: Demographic and physical data were extracted from Athlete Health Organization (AHO) 2018 pre-participation physical exams. Adiposity classifications were made from body mass index (BMI) calculations applied to appropriate Centers for Disease Control and Prevention (CDC) growth charts, while systolic/diastolic measurements were used to classify students’ blood pressure according to current American Academy of …

War On The Wards: The Collapse Of Health Care Infrastructure Resulting From Violent Conflict, Nathan Hersh, Amy Hagopian, Barry Levy

Phase 1

Introduction: While utilizing satellite images to verify reports of hospital damage resulting from armed conflict allows for remote assessment, the use of private satellites to gain access to images prohibits widespread use. The questions this study sought to answer were: Is it possible to replicate the findings of previous reports of hospital damage that used the services of private satellite imagery using open source software, such as Google Earth? What variations exist among the different sites where damage to hospitals is visible, and what gradation is possible? Is this methodology applicable to other examples of armed conflict?

Methods: Using the …

Efficacy Of Existing Interventions For Health Care Provider Stress & Implications For Low-Resource Health Care Settings: A Systematic Review, Ann Marie Kelly, Ms, Patience Afulani, Mbchb, Mph, Phd

Phase 1

Introduction: There is a demand for interventions that may help providers cope with inevitably high levels of stress, but there is a paucity of data on the efficacy/feasibility of interventions for provider stress/burnout—particularly in low-resource settings. This study examined existing interventions and their effectiveness in combatting stress and burnout among providers.

Methods: The traditional format of a systematic review was employed utilizing PubMed, PsycInfo, and SCOPUS to examine stress and burnout interventions offered to health care providers. Primary outcomes of stress/burnout were analyzed through the use of validated resilience scores. This study initially identified 1,720 records; twelve studies were included …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Health Outcomes In Pathways To Housing Clients, Kimberly Alfonso, Lara Weinstein, Md

Phase 1

Introduction: Homelessness is widespread throughout the United States, with homeless individuals accounting for over half a million of the country’s population. In addition, chronic mental, behavioral, and medical issues are overly expressed in this population. Therefore, the purpose of this project was to determine if the Housing First Model, represented by Pathways to Housing PA, would alleviate these chronic conditions over the course of stay.

Methods: The target population of the study was the homeless population, specifically within the city of Philadelphia. Data was collected via the SAMHSA (Substance Abuse and Mental Health Services Administration) NOMs (National Outcome Measures) survey. …