Translational Medical Research Commons^™

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

The Design, Implementation And Evaluation Of A Technology Solution To Improve Discharge Planning Communication In A Complex Patient Population, Susan M. Manfredi

Doctor of Nursing Practice (DNP) Projects

Unnecessary delays in discharge planning can extend the length of stay (LOS) and add non-reimbursable days for socially and medically complex patients thereby increasing the financial burden to healthcare organizations. The literature supports enhanced discharge communication strategies and the use of checklists to facilitate safe and timely discharges. Following root cause analyses of significant discharge delays, one hospital identified gaps in communication as key precursors associated with discharge planning breakdown when discharging patients to skilled nursing facilities. Review of these events demonstrated the need for concurrent communication strategies between multidisciplinary care team members in planning for complex discharges.

Following a …

Acceptance Of Disability And Its Predictors Among Stroke Patients In Taiwan, Shan-Yun Chiu, Hanoch Livneh, Long-Lung Tsao, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Modern medicine has increased the survival rate for stroke patients; however, the patient’s psychosocial adaptation after stroke onset may be related to the clinical outcomes. This study aimed to investigate patients’ acceptance of disability (AOD) and its predictors in stroke patients. Methods: This cross-sectional study used a purposive sampling method to recruit 175 stroke patients from a hospital in southern Taiwan. A structured questionnaire gathered data on respondent demographics and disease characteristics, and included the Chinese version of the AOD Scale-Revised. Factors associated with AOD were examined by a multiple linear regression analysis. Results: The mean AOD score was …

Up North They’Re Talking Sex: A Collaborative And Community Driven Model For Sexual Health Knowledge Mobilization, Karen Edwards, Steve Mitchell Phd, Nancy Gibson Phd, Cecilia Zoe-Martin, Anita Daniels, Jim Martin, Patrick Wansbrough Rn

Journal of Health Disparities Research and Practice

To address high STI rates in their aboriginal communities, the Tłı̨chǫ of the Northwest Territories adopted a collaborative participatory research approach to sexual health based on four key stages of development. First was community initiation and engagement, where local leaders identified a priority need and began community discussions around sexual health. Secondly, identifying that existing government statistics did not provide them with adequate information, the Tlicho Community Services Agency partnered with the University of Alberta and CIETcanda to conduct a baseline study in all four Tlicho communities, designed and administered by community-based researchers. Third, a community action research team (CART) …

Expert–Novice Differences In Mental Models Of Viruses, Vaccines, And The Causes Of Infectious Disease, Benjamin D. Jee, David H. Uttal, Amy N. Spiegel, Judy Diamond

World of Viruses

Humans are exposed to viruses everywhere they live, play, and work. Yet people’s beliefs about viruses may be confused or inaccurate, potentially impairing their understanding of scientific information. This study used semi-structured interviews to examine people’s beliefs about viruses, vaccines, and the causes of infectious disease. We compared people at different levels of science expertise: middle school students, teachers, and professional virologists. The virologists described more entities involved in microbiological processes, how these entities behaved, and why. Quantitative and qualitative analyses revealed distinctions in the cognitive organization of several concepts, including infection and vaccination. For example, some students and teachers …

I'M A Patient, Not A Problem: An Exploration Into The Roles Assigned In The Doctor-Patient Relationship, Monica C. Stewart

Honors Theses and Capstones

No abstract provided.

Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden

Oglethorpe Journal of Undergraduate Research

This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21^st century, the world still battles inadequate healthcare. Nations continue to strive towards …

Omega-3 Fatty Acids Reduce Adipose Tissue Macrophages In Human Subjects With Insulin Resistance, Michael Spencer, Brian S. Finlin, Resat Unal, Beibei Zhu, Andrew J. Morris, Lindsey R. Shipp, Jonah D. Lee, R. Grace Walton, Akosua Adu, Rod Erfani, Marilyn S. Campbell, Robert E. Mcgehee Jr., Charlotte A. Peterson, Philip A. Kern

Clinical and Translational Science Faculty Publications

Fish oils (FOs) have anti-inflammatory effects and lower serum triglycerides. This study examined adipose and muscle inflammatory markers after treatment of humans with FOs and measured the effects of ω-3 fatty acids on adipocytes and macrophages in vitro. Insulin-resistant, nondiabetic subjects were treated with Omega-3-Acid Ethyl Esters (4 g/day) or placebo for 12 weeks. Plasma macrophage chemoattractant protein 1 (MCP-1) levels were reduced by FO, but the levels of other cytokines were unchanged. The adipose (but not muscle) of FO-treated subjects demonstrated a decrease in macrophages, a decrease in MCP-1, and an increase in capillaries, and subjects with the most …

An Acacb Variant Implicated In Diabetic Nephropathy Associates With Body Mass Index And Gene Expression In Obese Subjects, Lijun Ma, Mariana Murea, James A. Snipes, Alejandra Marinelarena, Jacqueline Krüger, Pamela J. Hicks, Kurt A. Langberg, Meredith A. Bostrom, Jessica N. Cooke, Daisuke Suzuki, Tetsuya Babazono, Takashi Uzu, Sydney C. W. Tang, Ashis K. Mondal, Neeraj K. Sharma, Sayuko Kobes, Peter A. Antinozzi, Matthew Davis, Swapan K. Das, Neda Rasouli, Philip A. Kern, Nathan J. Shores, Lawrence L. Rudel, Matthias Blüher, Michael Stumvoll, Donald W. Bowden, Shiro Maeda, John S. Parks, Peter Kovacs, Robert L. Hanson, Steven C. Elbein, Barry I. Freedman

Clinical and Translational Science Faculty Publications

Acetyl coenzyme A carboxylase B gene (ACACB) single nucleotide polymorphism (SNP) rs2268388 is reproducibly associated with type 2 diabetes (T2DM)-associated nephropathy (DN). ACACB knock-out mice are also protected from obesity. This study assessed relationships between rs2268388, body mass index (BMI) and gene expression in multiple populations, with and without T2DM. Among subjects without T2DM, rs2268388 DN risk allele (T) associated with higher BMI in Pima Indian children (n = 2021; p-additive = 0.029) and African Americans (AAs) (n = 177; p-additive = 0.05), with a trend in European Americans (EAs) (n = 512; p-additive = 0.09), but not …

Jefferson Interprofessional Clinical Rounding Project: An Innovative Approach To Patient Care, Kevin J. Lyons Phd, Gerald Isenberg Md, Facs, Elizabeth Speakman Edd, Rn, Cde, Anef, Reena Antony Bsn, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Role Of Dax-1 In Regulating Pluripotency In Mouse Embryonic Stem Cells, Anthony Torres

Master's Theses

The orphan receptor Dax-1 is highly expressed in pluripotent embryonic stem (ES) cells and shows a correlative reduction in expression as these cells differentiate. While it is known that Dax-1 is expressed in pluripotent mouse ES cells, the precise function of Dax-1 in these cells is not as well understood. Recent studies employing RNA interference (RNAi) to specifically reduce the expression of the Dax-1 gene in mouse ES cells found that upon the knock down of Dax-1, ES cells differentiated. These findings indicate that Dax-1 functions in a novel role in the maintenance of a relatively undifferentiated state in ES …

Jefferson Hosts Third Interprofessional Education Conference, Kevin Lyons Phd, Christine Arenson Md, Elizabeth Speakman Rn, Phd, Carolyn Giordano Phd

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Genetic Risk Factors For Type 2 Diabetes: A Trans-Regulatory Genetic Architecture?, Steven C. Elbein, Eric R. Gamazon, Swapan K. Das, Neda Rasouli, Philip A. Kern, Nancy J. Cox

Clinical and Translational Science Faculty Publications

To date, 68 loci have been associated with type 2 diabetes (T2D) or glucose homeostasis traits. We report here the results of experiments aimed at functionally characterizing the SNPs replicated for T2D and glucose traits. We sought to determine whether these loci were associated with transcript levels in adipose, muscle, liver, lymphocytes, and pancreatic β-cells. We found an excess of trans, rather than cis, associations among these SNPs in comparison to what was expected in adipose and muscle. Among transcripts differentially expressed (FDR < 0.05) between muscle or adipose cells of insulin-sensitive individuals and those of insulin-resistant individuals (matched on BMI), trans-regulated transcripts, in contrast to the cis-regulated ones, were enriched. The paucity of …

The Effects Of A Group Visit Program On Outcomes Of Diabetes Care In An Urban Family Practice., Jeffrey A Reitz, Mona Sarfaty, James Diamond, Brooke Salzman

Department of Family & Community Medicine Faculty Papers

Diabetes mellitus is a prevalent chronic health condition associated with significant morbidity and mortality. Those with diabetes must acquire self-efficacy in the tasks necessary for them to successfully manage their disease. In this study, a controlled pre- and post-design was used to determine the effect of an adult support and education group visit program embedded in an urban academic family medicine practice on weight and the achievement of treatment goals for hemoglobin A1C, low-density lipoprotein (LDL) blood concentration, and blood pressure (BP) several months after it was implemented. Participants in the program were matched to a comparison group based on …

Community-Based Partnerships For Improving Chronic Disease Management, James Plumb, Laura Carson Weinsten, Rickie Brawer, Kevin Scott

Department of Family & Community Medicine Faculty Papers

With the growing burden of chronic disease, the medical and public health communities are re-examining their roles and opportunities for more effective prevention and clinical interventions. The potential to significantly improve chronic disease prevention and have an impact on morbidity and mortality from chronic conditions is enhanced by adopting strategies that incorporate a social ecology perspective, realigning the patient-physician relationship, integrating population health perspectives into the Chronic Care Model, and effectively engaging communities using established principles of community engagement.

Copyright © 2012 Elsevier Inc. All rights reserved.

European Union Food Law Update, Emilie Majster

Journal of Food Law & Policy

Nutrition is increasingly important in both the European Union (EU) and in global food-related policy making. Governments, which up until recently have focused on regulating food products based on a food safety perspective, are now turning to regulate from a nutritional aspect.

Provision Of Pandemic Disease Information By Health Sciences Librarians: A Multisite Comparative Case Series., Robin Featherstone, Gabriel Boldt, Nazi Torabi, Shauna-Lee Konrad

Western Libraries Publications

Objective: The research provides an understanding of pandemic information needs and informs professional development initiatives for librarians in disaster medicine. Methods: Utilizing a multisite, comparative case series design, the researchers conducted semi-structured interviews and examined supplementary materials in the form of organizational documents, correspondence, and websites to create a complete picture of each case. The rigor of the case series was ensured through data and investigator triangulation. Interview transcripts were coded using NVivo to identify common themes and points of comparison. Results: Comparison of the four cases revealed a distinct difference between “client-initiated” and “librarian-initiated” provision of pandemic information. Librarian-initiated …

Research Annual Report 2012, Children's Mercy Hospital

Research Annual Reports

Annual report of the research at Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

The Career Support Network (Csn): Workforce Programming Through A New Lens, Rickie Brawer, Mph, Phd, James D. Plumb Md, Mph, Stephen Kern, Phd, Otr/L, Faota

Department of Family & Community Medicine Faculty Papers

Challenges:

Loss of Earn center as referral source

Multiple IRB submissions

Training/orientation at Philadelphia Prison System for working with pre-release prisoners

Service team organization/scheduling

Coordinating of cohorts at various stages of enrollment

Sepa-Reads: Cardiovascular Health Literacy Coalition, Rickie Brawer, Mph, Phd, James D. Plumb Md, Mph, Rob Simmons Drph,Mph,Ches, Martha Romney Rn,Ms,Jd,Mph, Patricia Yurchick, Rn, Mba, Cphq, Leslie Stearns

Department of Family & Community Medicine Faculty Papers

Poster includes:

Health literacy definition

Factors that contribute to health literacy

Extent of the literacy problem

What do we know from a decade of research?

Readmission rates

Evaluation: long and short term outcomes

And much more.