Family Medicine Commons^™

Information Fusion And Quantum Logic In Family Medicine, F. Matthew Mihelic

Faculty Publications

A time-tested model for information fusion and analysis is provided by Family Medicine. Family Medicine is a discipline that operates in the realms of botJ1 technical and social sciences to analyze massive amounts of information from mulriple sources in order to make decisions that bring about tJie integration and coordination of interdisciplinary interventions involving scientific, psychological, and social aspects of medical care. This generalist function serves to lower the organizational entropy of complex systems and thereby improve efficiency while reducing ilie risk of catastrophic failure. Simply bringing a group of specialists together in one place does not bring about the …

Sindh Health Sector Strategy 2012 – 2020, Shehla Zaidi

Community Health Sciences

No abstract provided.

Vaccine-Preventable Diseases And Foreign-Born Populations, Marc Altshuler, Md, Giang Nguyen, Md

Department of Family & Community Medicine Faculty Papers

Foreign-born individuals account for over 12% of the U.S. population, according to the most recent census data. Since many vaccine-preventable outbreaks in the U.S. have been correlated with disease importation, Congress has mandated vaccinations for numerous immigrant populations. It is essential for primary care physicians to be knowledgeable on the unique immunization-related needs of foreign-born individuals, to recognize some of the cultural and linguistic challenges that immigrants have accessing healthcare, and remember to use each medical encounter as an opportunity to provide necessary vaccinations.

Individual Agency, Community Capacity Building, And Chronic Illness Care: Using Participatory Methods To Implement The Stanford Chronic Disease Self Management Program In A Housing First Program, Lara Carson Weinstein, Md, Mph, Abbie Santana, Msph, Carolyn Armour, Cornelius Crossan, James Lawson, Karen Webb

Department of Family & Community Medicine Presentations and Grand Rounds

Research questions:

Is a standardized chronic disease self management program (CDSMP) experienced as a valuable intervention by Pathways' consumers?

What is the impact of collaborative inquiry into health program development on participant's critical agency?

Participatory Research At Pathways To Housing-Pa: A Consumer Perspective, Patways To Housing Consumer Health Research Team And Department Of Family And Community Medicine

Department of Family & Community Medicine Presentations and Grand Rounds

Research Question: How does housing affect healthcare decision making?

Methods: 11 Clients took part in a 9-week project focused on health. Using qualitative methodology, weekly meetings were recorded, transcribed, then analyzed resulting in the development of thematic findings.

Baseline Monitoring Of Standard Health Indicators In A Formerly Homeless Population, Lara Carson Weinstein, Md, Mph, Marianna Lanoue, Phd, Elizabeth Collins, Bs

Department of Family & Community Medicine Presentations and Grand Rounds

Research Question: What are the rates of baseline health status indicators recording at Pathways to Housing (PTH) using select recommended measures from the National Association of State Mental Health Program Directors (NASMHPD) and the Healthcare Effectiveness Data Information Set (HEDIS)?

How do health indicators compare between clients receiving direct clinical care in the integrated care program vs non-integrated care clients?

Cervical Cancer Screening Outcomes In A Refugee Population, Sarah Pickle, Md, Marc Altshuler, Md, Kevin Scott, Md, Christina Hillson, Md, R. Patrick Mcmanus, Md, Mazvita Nyamukapa, Michael Walker

Department of Family & Community Medicine Presentations and Grand Rounds

The purpose of our study was to determine the prevalence of abnormal Pap smears and high-risk HPV genotypes within our refugee population.

Pediatric Telebehavioral Health In Rural Primary Care: An Electronically-Mediated Warm Handoff, J. A. Correll, Jodi Polaha

ETSU Faculty Works

No abstract provided.

Performance Of Colorectal Cancer Screening Steps In Primary Care, Salini Mohanty, Mph, Mona Sarfaty, Md, Mph, Faafp, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Discussion:

This analysis revealed the differences in which physicians in primary care complete CRC screening steps. The approach and completion of screening steps varied greatly among practices.

There was a correlation between the quantitative data and the qualitative data. The analysis from both methodologies produced similar results and supports each other's assessment.

All of the practices analyzed possessed one of the essential elements (a physician recommendation) which is the foundation for increased screening. All of the practices have the potential to expand upon this foundation in order to ensure that all eligible patients are approached and screened for CRC.

The …

Capacity Building For Participatory Health Services Research In Housing First, Lara Carson Weinstein, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Background:

Pathways to Housing ends chronic homelessness for individuals with serious mental illness (SMI) by providing housing first, and then combining that housing with supportive treatment services in the area of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This "scattered site" model fosters a sense of home and self-determination, and it helps speed client's reintegration into the community. The Pathways model has been remarkable successful in addressing chronic homelessness.

Research Question

What are the chronic physical disease self management support needs of Pathways to Housing clients?

Preventable Lifestyle Risk Factors For Non-Communicable Diseases In The Pakistan Adolescents Schools Study 1 (Pass-1)., Ali Khan Khuwaja, Saleem Khawaja, Komal Motwani, Adeel Khoja, Iqbal Azam Syed, Zafar Fatmi, Badar Sabir Ali, Muhammad Masood Kadir

Department of Medicine

Objectives: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents.

Methods: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis.

Results: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% …

Obesity And Other Predictors Of Absenteeism In Philadelphia School Children., Elizabeth B Rappaport, Constantine Daskalakis, Jocelyn Andrel

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Limited data indicate that obese children are absent from school more than their normal-weight peers. We analyzed administrative data from a large urban school district to investigate the association of obesity and student sociodemographic characteristics with absenteeism.

METHODS: We analyzed 291,040 records, representing 165,056 unique students (grades 1-12). Obesity status was classified according to Centers for Disease Control and Prevention age- and sex-specific percentiles for body mass index (BMI) and analyses were based on negative binomial regression.

RESULTS: Overall rates of overweight and obesity were 17% and 20%, respectively, and the estimated absence rate was 17 absences per 180 …

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

Obesity And Cancer Screening According To Race And Gender., Heather Bittner Fagan, Richard Wender, Ronald E Myers, Nicholas Petrelli

Department of Family & Community Medicine Faculty Papers

The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA) testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC) screening, the …

Re: Sleep And The Family Doctor: Time To Lead, D. Bluestein, A. C. Healey, C. M. Rutledge

Ellmer School of Nursing Faculty Publications

No abstract provided.

The Life And Times Of A Kansas Horse And Buggy Doctor And His Recollections On The Care Of Children, Robert D. Schremmer Md, Jane F. Knapp Md

Posters

Describes the career of Arthur Emmanuel Hertzler, MD, 1870-1946, who practiced in Halstead, Kansas.

Patient Perceptions Of Physician Empathy, Satisfaction With Physician, Interpersonal Trust, And Compliance, Mohammadreza Hojat, Daniel Z. Lewis, Kaye Maxwell, Fred Markham, Richard Wender, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance.

Methods: Research participants included 535 out-patients (between 18-75 years old, 66% female). A survey was mailed to participants which included the JSPPPE (5-item), a scale for measuring overall satisfaction with the primary care physician (10-item), and demographic questions. Patients were also asked about compliance with their physician's recommendation for preventive tests (colonoscopy, mammogram, and PSA for age and gender …

End-Of-Life Care For Hospitalized Patients With Lung Cancer: Utilization Of A Palliative Care Service., Barbara Reville, M.S., Achpn, Marshal N Miller, B.S., Richard W Toner, M.S., Joanne Reifsnyder, Ph.D., Achpn

Department of Family & Community Medicine Faculty Papers

PURPOSE: High symptom burden and hospital mortality among patients with lung cancer argues for early palliative care intervention. Patient characteristics and discharge dispositions in hospitalized patients with lung cancer receiving usual care were compared to those referred to a new palliative care service.

METHODS: A retrospective database review of all lung cancer discharges receiving usual care (UC) and palliative care service (PCS) consultation was conducted. Demographics, length of stay, discharge disposition, and mortality were described and compared. Palliative Performance Scale scores were described according to discharge disposition in the PCS group. Disposition of all patients receiving either chemotherapy or surgery …

Transforming Chronic Care Education: A Longitudal Interprofessional Mentorship Curriculum, Lauren G. Collins, Md, Christine A. Arenson, Md, Christine Jerpbak, Md, Elena Umland, Pharmd, Stephen B. Kern, Phd, Otr/L, Faota, Leigh Ann Hewston, Pt, Med

Department of Family & Community Medicine Faculty Papers

Rationale:

Future state of academic medicine demands preparing students for collaborative, team-based practice.

Interprofessional education (IPE) is widely advocated as a key element to promote an effective redesigned healthcare system

Evidence and curricular resources describing effective IPE remain limited

Screening Of Hepatitis B And C Among People Visiting General Practice Clinics In A Rural District Of Sindh, Pakistan., Ameet Kumar, Saima Lalani, Asad Ali Khan Afridi, Ali Khan Khuwaja

Community Health Sciences

BACKGROUND:

Hepatitis B (HB), Hepatitis C (HC) and their risk factors are amongst the major health problems in developing countries including Pakistan. This study aimed to screen for HB and HC among people who visited General Practice clinics and also to identify the differences of screening positive cases by age and sex.

METHODS:

This was a retrospective study conducted in Tando Muhammad Khan city, one of the rural districts of Sindh. All together we reviewed 5989 laboratory reports of people for hepatitis B and C on consecutive basis from two laboratories. A pre-designed and structured perform was used to collect …