Medicine and Health Sciences Commons^™

Hour Prediction Rule - Letter To The Editor., Andrew L. Koons Do, Robert D. Cannon Do, Facmt, Gillian A. Beauchamp Md, Kenneth D. Katz Md, Matthew D. Cook Do, Ryan M. Surmaitis Do

Department of Emergency Medicine

In a recent issue of Academic Emergency Medicine, we read with interest the article titled: Hospital Observation Upon Reversal (HOUR) with Naloxone: A Prospective Clinical Prediction Rule Validation Study by Clemency et al. In order to avoid over-reliance on this decision rule and possible untoward effects of early discharge, we feel that there are some key points worth considering in this regard. It is important to note that the average dose of prehospital naloxone was 3.1mg, which was administered intranasally (IN) in 85% of the patients. This fact was briefly discussed in the paper in terms of area under the …

Feasibility Of Implementation Of An Emergency Department Discharge Opioid Taper Protocol, Gillian A. Beauchamp Md, Joshua Rosentel Bsn, Rn, Erin Farber Do, Joseph Levi Do, Dpt, Lexis Laubach Bs, Lauren Crowley Ba, Richard S. Mackenzie Md, Mboe, David M. Richardson Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Do Female Residents Actually Demonstrate Better Levels Of Empathy, Emotional Intelligence And Burnout Than Their Male Counterparts?, Jeanne L. Jacoby Md, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Robert D. Barraco Md, Mph, Elaine A. Donoghue Md, Kevin Weaver D.O.,Facoep, Jennifer E. Macfarlan Mph, Alexander M. Rosenau Do, Joann F. Quinn Phd, Amy B. Smith Phd

Department of Emergency Medicine

No abstract provided.

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 68, Issue 2, Fall 2019

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• Dean's Column - The 195th Commencement of SKMC
• Perspectives
• On Campus
• A Message from Elizabeth A. Dale - Reimagine Jefferson
• Discovery - Know Thy Self
• Seeing the Holistic Picture - Integrative medicine is taking techniques from the past to change the future of healthcare - and Jefferson is leading the charge
• Faculty Profile - David Nash, MD, MBA
• Student Profile - Carrie Walsh
• Alumni Profile - Austin Chiang, MD, MPH, GI Fellow '18
• Class Notes
• Class Agent
• In Memoriam
• By the Numbers - The Class of 2023

Routine Late Trimester Ultrasound For The Detection Ofsmall-For-Gestational-Age And Growth-Restricted Fetus Inlow-Risk Pregnancy: A Randomised Controlled Trial, Sikolia Wanyonyi, Doreen Osoro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. …

Decreasing Time To Initiation Of Chemotherapy For Patients Electively Admitted To A Hematologic Malignancy Service., Jose N Galeas, Stuart Packer, Roy Browne, Susan Sakalian, Adam F. Binder

Department of Medical Oncology Faculty Papers

Background: Delays in initiating elective inpatient chemotherapy can decrease patient satisfaction and increase length of stay. At our institution, we observed that 86% of patients admitted for elective chemotherapy experienced a delay (greater than 6 hours) with a median time to chemotherapy of 18.9 hours. We developed a process improvement initiative to improve time to chemotherapy for elective chemotherapy admissions.

Methods: Our outcome measure was time from admission to chemotherapy administration in patients admitted for elective chemotherapy. Process measures were identified and monitored. We collected baseline data and utilized performance improvement tools to identify key drivers. We focused on these …

Teaching An Old Pain Medicine Society New Tweets: Integrating Social Media Into Continuing Medical Education., Kellie M Jaremko, Eric S Schwenk, Amy C S Pearson, Jonathan Hagedorn, Ankeet D Udani, Gary Schwartz, Nabil M Elkassabany, Anne Snively, Edward R Mariano

Department of Anesthesiology Faculty Papers

No abstract.

Health Inspectors On Local Boards Of Health: The Impact On Communities’ Environmental Health Governance, Jeff Jones, Asli Aslan, Ginger Fenton

Journal of the Georgia Public Health Association

Background: This study examines whether having a required health inspector on a local board of health (LBOH) improves the board’s information on environmental health.

Methods: Analysis uses the national random sample of 351 U.S. LBOHs in the 2011 Profiles collected by the National Association of Local Boards of Health (NALBOH) and examines whether having a required health inspector on a LBOH increases the likelihood it receives information on 10 environmental health topics.

Results: LBOHs overall received little information on environmental health, and 48% reported wanting no or little additional information. Having a required health inspector on a LBOH did not …

Eyelid Chalazion Or Not?, Jerry A. Shields, Sara E. Lally, Tatyana Milman, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Vascular Perfusion In Persistent Pupillary Membrane Of The Iris., Michael Chang, David Ancona-Lezama, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Dormant Pathogenic Cd4(+) T Cells Are Prevalent In The Peripheral Repertoire Of Healthy Mice, Anna Cebula, Michal Kuczma, Edyta Szurek, Maciej Pietrzak, Natasha Savage, Wessam R. Elhefnawy, Grzegorz Rempala, Piotr Kraj, Leszek Ignatowicz

Computer Science Faculty Publications

Thymic central tolerance eliminates most immature T cells with autoreactive T cell receptors (TCR) that recognize self MHC/peptide complexes. Regardless, an unknown number of autoreactive CD4+Foxp3⁻ T cells escape negative selection and in the periphery require continuous suppression by CD4+Foxp3⁺ regulatory cells (Tregs). Here, we compare immune repertoires of Treg-deficient and Treg-sufficient mice to find Tregs continuously constraining one-third of mature CD4⁺Foxp3⁻ cells from converting to pathogenic effectors in healthy mice. These dormant pathogenic clones frequently express TCRs activatable by ubiquitous autoantigens presented by class II MHCs on conventional dendritic cells, including selfpeptides that select …

Fall 2019

Scientia

Education Taking Flight; The Vincentian Question and the Chemistry Teacher; Science Goes Global; Minister of Hope: Neurosurgeon and cancer researcher Alfredo Quinones-Hinojosa, MD, believes hope is more powerful than fear; What's New: The college introduced four new programs and tracks in its offerings for the 2019-20 academic year; Lab Notes; A Teacher Who Really Counts: Golden Apple Recipient Candice Cortese (CSH MA '10) Reflects on her Love of Teaching Math; One Smart Cookie: Chemistry Student Lucienna Wolf Says, "If You Really Apply Yourself, the Teachers Are More Than Happy to Help You."

Health Expenditure And Utilization Survey Thatta District, 2019, Muhammad Ashar Malik, Wajeeha Raza, Riaz Karimi

Community Health Sciences

No abstract provided.

69-Year-Old Male After Gastric Bypass With Choledocholithiasis Treated With Edge Procedure Complicated By Lams Dislocation, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

Use Of Machine Learning Algorithms For Prediction Of Fetal Risk Using Cardiotocographic Data, Zahra Hoodbhoy, Mohammad Noman, Ayesha Shafique, Ali Nasim, Devyani Chowdhury, Babar Hasan

Department of Paediatrics and Child Health

Background: A major contributor to under-five mortality is the death of children in the 1^st month of life. Intrapartum complications are one of the major causes of perinatal mortality. Fetal cardiotocograph (CTGs) can be used as a monitoring tool to identify high-risk women during labor.
Aim: The objective of this study was to study the precision of machine learning algorithm techniques on CTG data in identifying high-risk fetuses.
Methods: CTG data of 2126 pregnant women were obtained from the University of California Irvine Machine Learning Repository. Ten different machine learning classification models were trained using CTG data. Sensitivity, precision, …

Overcoming Brick And Mortar: Feasibility Of Implementation Of A Mat And Linkage To Treatment Program By Leveraging Community Partnerships, Gillian A. Beauchamp Md, Priyanka Lauber Do, Jamie Allen Do, Nathan Boateng Ba, Samantha A. Shaak Phd, Paige Roth Msw, Lsw, Crs, Lexis Laubach Bs, Lauren M. Crowley Ba, David B. Burmeister Do, Facep, Cpe, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

No abstract provided.

Do Incoming Residents Vary In Measures Of Emotional Status Even Prior To Residency Training?, Jeanne L. Jacoby Md, Bryan G. Kane Md, Marna R. Greenberg Do, Mph, Facep, Robert D. Barraco Md, Mph, Elaine A. Donoghue Md, Kevin Weaver D.O.,Facoep, Jennifer E. Macfarlan Mph, Alexander M. Rosenau Do, Joann F. Quinn Phd, Amy B. Smith Phd

Department of Emergency Medicine

No abstract provided.

Police Use Of Naloxone After Statewide Legislation Enabling First-Responder Administration, John F. Mccarthy Do, Kathryn A. Henry Do, Lauren Crowley Ba, David M. Sassa Aas, Kira D. Weaver Do, Robert D. Cannon Do, Tara K. Henry-Morrow Emt-P, Jennifer E. Macfarlan Mph, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

A Study Of Scars: Narratives Of Unintentional Childhood Injuries In Cato Manor, Carolyn Fox

Independent Study Project (ISP) Collection

The purpose of this study is to identify the specific types of injuries children experience growing up in Cato Manor, specifically, KwaMasxha, to understand how community members process and make meaning of their injuries over time, and to analyze the social determinants of health in Cato Manor that have been conducive to these injuries.

In order to learn about experiences of unintentional childhood injuries in Cato Manor, data was collected using a qualitative, narrative-based approach. I conducted interviews with young adult community members aged 19 to 27 years, asking about their personal experiences with childhood injuries as someone who grew …

Health And Education: Perspectives On The Role Of Schools In Health Promotion, Miranda Powell

Independent Study Project (ISP) Collection

The purpose of this study was to understand learners’ perceptions of the role schools play in health promotion. Health promotion encompasses health education and can be highly effective in the school setting. Given the high rates of HIV/AIDS, teen pregnancy, early sexual debut, and abuse, health education is highly important in South African schools. All learners are required to take Life Orientation classes, which cover many topics including health education. Comparing the views of what learners expect, experience, and the curriculum, my study addressed the gaps in Life Orientation classes with regards to health promotion education.

For this study I …

Disability And Migration: How Systems Of Violence Intersect With The Production And Experience Of Disability For Migrants In Morocco, Frances Condon

Independent Study Project (ISP) Collection

This project investigates the perspectives and experiences of physically disabled, chronically ill, or bodily-impaired migrants from south of the Sahara living in Rabat, Morocco. Increasing interest in disabled migrants’ rights from international organizations risks erasing those being ‘protected’ if it does not attend to the intersections of race, class, citizenship, and gender as they relate to the production and experience of disability for migrants. Produced by and for the (white) global North, I argue that traditional Euro-American disability studies scholarship is ill-equipped to address the issues faced by disabled migrants in post-colonial contexts. In addition to being ineffective, the uncritical …

Integrative Pharmacotherapeutic Approaches To Treating Depression, Charlotte Tse

Independent Study Project (ISP) Collection

Traditional Chinese Medicine (TCM), based in the philosophy-religions of Buddhism, Confucianism, and Daoism, is more than a purely prescriptive medical system; it is a way of life focused primarily on the principles of prevention rather than the more reactionary direction that pharmacotherapy in the US has taken. Mental illness is expected to account for a quarter of China’s overall health burden by 2020, with depression affecting around 100 million people and nearly 30 percent of young Chinese adults. Conventional antidepressants have a delayed onset and unpredictable therapeutic efficacy in this condition, especially in mild to moderate cases of depression. In …

Herbal Medicine And Pediatric Massage: Interning At A Tcm Pediatric Clinic, Yvette Way

Independent Study Project (ISP) Collection

Before entering this program my knowledge of TCM was practically nonexistent. However even from a young age, I had an interest in learning about the healing properties of plants and herbs but, I had no way of exploring this interest of mine. After entering this program, I have learned more about TCM and herbal medicine. Because of the lessons that we have taken in class, it made me want to have a deeper understanding of TCM because of this, I decided to do an internship that would involve TCM. My time at Yang Zhen Er Kang clinic has taught me …

The Hapless State Of Amyotrophic Lateral Sclerosis In India: A Comprehensive Look At Life And Medical Services For Als Patients In Rural Himachal Pradesh, Carson J. Bergström

Independent Study Project (ISP) Collection

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a neurodegenerative disorder that leads to paralysis. The disease requires a high amount of medical intervention and interdisciplinary focus to achieve quality of life for patients. This study looks at ALS patient’s lifestyles, their access to these medical devices, Indian therapeutic approaches and policy that impacts patients in Shimla, Himachal Pradesh. As caretakers have a critical part in the care for this disease, their lives were also considered in the case studies. It was found that ALS patients are not experiencing access to medical devices necessary for life because of physical …

Intersections Between Health And Disability: A Case Study At Disha Centre, Jaipur, Rajasthan, Finnian Brokaw

Independent Study Project (ISP) Collection

This study investigated intersections between health and disability by asking the question: how do community perceptions of disability at Disha: A Resource Centre for the Disabled in Jaipur, India relate to health and quality of life for a person with multiple disabilities? This study utilized a case study methodology. The researcher took qualitative interviews from six respondents in the immediate educational and familial support network of a 27-year-old man with multiple disabilities. An interview based, qualitative methodology was important for investigating the complexity of perceptions of multiple disabilities and health as intersecting identities. The responses were analyzed and reflected upon …

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

Perceptions Of Rural Birthing Practices: A Glimpse Into Maternal And Child Health For Women In Kangra District, Himachal Pradesh, Mackenzie Burke

Independent Study Project (ISP) Collection

Over the past two decades birthing practices within India have drastically changed. This change is most visible in the shift from homebirths to hospital births following the implementation of the National Rural Health Mission. This study aims to understand and give voice to women’s perceptions of birthing practices in the rural villages of Kangra District of Himachal Pradesh. A total of ten interviews were conducted with both mothers and healthcare practitioners in the surrounding villages of Kangra District in order to gain a thorough, qualitative understanding of birthing practices in the local communities. The healthcare practitioners’ responses were divided according …

Logistic And Structural Considerations For The Use Of Psychological First Aid In Humanitarian Emergencies, Taylor Johnson

Independent Study Project (ISP) Collection

Following the IASC recommendations for implementation of psychological first aid (PFA) in 2007, providing PFA in humanitarian emergencies as a method of psychosocial support has become one of the standard interventions in the wake of crises. However, the impact of PFA on future mental health outcomes remains largely unstudied and many structural and logistic factors (e.g. training of PFA providers, reviewing evidence to inform practice, and policy considerations) must be managed in order to ensure appropriate, high-quality PFA in humanitarian emergencies. This research aims to synthesize both primary interview data and the existing literature surrounding PFA in humanitarian emergencies to …

Finding A Common Ground Between Theology And Women’S Reproductive Rights: Assessing The Societal Levels Of Influence Of Religion On The Sexual And Reproductive Health Of Women, Natalie Montufar

Independent Study Project (ISP) Collection

The principle aim of this study is to explicate and elucidate the intersection between religious beliefs and practices and Sexual and Reproductive Health throughout distinct levels of society in the developing world. A literature review identified relevant peer-reviewed and grey literature on religious beliefs held on sexuality and procreation, the landscape of influence of religion on laws and policies at a national and international level, the effects of religion on individual sexual behavior, and modern interventions aiming to be culturally and religiously sensitive. The intricacies and nuances of three Abrahamic faiths were assessed to highlight the dogma of sacred texts …

Pensaba Que Te Había Olvidado: El Daño Duradero De La Trauma Que Viene De Tortura En La Dictadura Chilena, Antonia Mcdonnell Capossela

Independent Study Project (ISP) Collection

Research question: Is there a more useful model to characterize the torture that was implemented in Chile using the context of theory and history to establish an in-depth understanding of the symptomology and effects of the experience of torture survivors?

Objective: The general objective of this study is to establish the origin of the methods of torture used during the Pinochet dictatorship and use these results to suggest a model of reparations that is more wholistic. The specific objectives are to understand the intervention and instruction by the CIA in Chile, to study the testimonies of torture during the dictatorship …