The Correlation Between Perceptions of Safety and Perceived Stress Among Residents of the Somerset Neighborhood of Kensington, Philadelphia

Background: The Somerset neighborhood of Kensington, Philadelphia is affected by economic, environmental, and social issues that come with disinvestment. The average median income for Somerset is $26,015 per year which is much lower than Philadelphia’s city-wide income of$36, 957. This study evaluated the connection between perceptions of safety and perceived stress among residents of the Somerset neighborhood. Methods: This study was a secondary data analysis from a cross-sectional study in the Somerset neighborhood. The data included self-reported surveys from Somerset residents that were completed at their homes. The surveys were completed using an electronic (tablet) format which took approximately 20 to 30 minutes to complete. Trained members of the neighborhood collected the data from July to December 2017. We used SPSS to quantify relationships between perceptions of safety and perceived stress using Spearman’s Rank Order Correlation for each of our 12 perceptions of safety variables and stress. Our final model was created using a multivariable linear regression model. Results: We had 328 adults with an average age of 48 years old in our study sample. We found that most of the residents were female, 35.3% were Latino, predominantly single, and mainly employed full-time. Additionally, over half of the residents owned their home and 16 years was the average amount of time lived in the neighborhood. We found that the average score on the stress scale was a 5.18 (range 0-16). In our final model, we found 4 variables to be statistically significant (α= .10) age, years lived in the community, police should spend more time working with community members and groups to solve problems, and members of my community are interested in crime prevention activities. Discussion: Overall, the mean stress levels were lower than we expected. We found associations between demographics and perceptions of safety variables specifically, as age increased, stress decreased and as the years lived in the community increased, stress increased. Our results also indicated as police spent more time working with community members and as crime prevention activities increased in the community, stress decreased. The strongest predictor of stress was the variable: “police should spend more time working with community members and groups to solve problems.” Collaborations between police officers and community members have the potential to improve health and may also help residents feel safer and less stressed in the neighborhood

Understanding Differences in Medical Versus Surgical Patients Alerted by the Modified Early Warning Score (MEWS) at Jefferson Hospital

An Early Warning Score (EWS) is a risk-management tool to identify patients experiencing clinical deterioration early, therefore allowing timely treatment to occur. Although EWS scores are recommended for all in-patients, more data is available for patients under general medical services compared to surgical services. This study aims to understand differences between medical versus surgical in-patients who receive a red alert from the Modified Early Warning Score (MEWS) at Jefferson hospital. Patients who received a red MEWS alert during admission and discharged between June 2017 to March 2018 (N=812) were categorized as medical or surgical patients. Patient characteristics were compared using an independent samples t-test (age, alert count) or chi-square test (sex, race, admission source, insurance). Patient outcomes were compared using a binary logistic regression (in-hospital mortality, RRT, sepsis diagnosis, ICU transfer, intubation, discharge to hospice) or a Cox regression model (length of stay), controlling for age, sex, and race. Compared to medical patients, surgical patients were younger by 2.7 years (p=0.026) and more likely to have a Commercial and/or Medicare category of insurance (OR=1.568, p=0.005). Surgical patients were more likely to have ICU transfer (OR=1.487, p=0.013) and intubation post-alert (OR=2.470, p=0.006), while less likely to be discharged early (HR=0.675,

The Association Between Opioid-Related Industry Payments and Opioid Prescribing at the Individual and Ecological Level in Pennsylvania

Objective: to understand how industry payments related to opioid products are associated with opioid prescribing in Pennsylvania. Methods: we merged the Open Payments data, Medicare Part D public use file, and Dartmouth Hospital Atlas of Health Care Hospital Service Areas from 2015 to analyze relationships between opioid related payments and opioid prescribing. We used a binomial regression model to investigate individual-level trends and a log-linear model to investigate Hospital Service Area-level trends. We mapped the distribution of opioid-related payments in Pennsylvania using GIS software. Results: One additional payment to a physician was associated with 4.2% higher opioid-prescribing rate (OR = 1.0418, 95% CI 1.0416-1.0420, Chi-Square(1) = 122678, p Conclusions: We found a positive association between opioid-related payments to physicians and opioid prescribing. Policy makers and administrators should consider revising rules related to pharmaceutical company marketing tactics and promote judicious opioid prescribing

Evaluating the Needs of Cancer Survivors through Focus Groups and Surveillance Data

Abstract: Introduction As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum. Methods Using data compiled from the 2015 Michigan Behavioral Risk Factor Survey (MiBRFS), the Cancer Registry, and focus groups, several areas of need amongst cancer survivors were identified. Results In focus groups cancer survivors identified the 27 needs that fell into three categories: improving health-related behavior, utilizing health care services, and receiving emotional support. The MiBRFS provided population estimates for 10 of the 27 needs that were identified by the survivors. Conclusions As the cancer survival rate increases, providers and public health workers must implement and promote services that provide care to patients from diagnosis to post-treatment. A population surveillance system, in conjunction with focus groups, can shed light onto the exact needs that must be addressed. Surveillance data can demonstrate the impact of public health interventions, like tobacco cessation policies and system change projects, which ultimately impact the health and quality of life of cancer survivors

Stalking Crime Trends in Maine, 2007-2011

In 2007, the Maine Statistical Analysis Center (SAC) opted to conduct a Maine Crime Victimization Survey (MCVS) because findings from the National Crime Victimization Survey (NCVS) could not be analyzed at the state level, particularly because of Maine’s predominantly rural geographic area and its aging population. With support from several statewide governmental agencies, the Maine SAC developed its own crime victimization survey to better understand the nature of criminal victimization in Maine, and to update crime trends and perceptions of crime in Maine. The Muskie School of Public Service (MSPS) staffs the Maine SAC and, as one of the largest public policy centers in the U.S., conducts extensive research activities under state and national partnerships, and has projects in every state in the nation. In 2011, the MSPS repeated the MCVS to update data from the previous survey. As in 2007, the Maine SAC and the Muskie School’s Survey Research Center obtained over 800 complete surveys from eligible Maine residents and weighted the results based on the Census Bureau’s American Community Survey for Maine and county population distributions from the 2010 census to ensure a representative sample of the statewide population. Data produced from the surveys are assessable by governmental agencies and statewide organizations to advocate for new laws, reduce victimization, and to provide services for victims of crime. This brief provides some in-depth analyses of data collected during the 2007 and 2011 surveys and focuses on stalking crimes. Analyses in the brief represent data with the weights removed and percentages may vary slightly from the full victimization reports

Anthelmintic Efficacy Trials using Fractionsof Ethanolic Crude Extract of Anogeissusschimperi Hoechst against Nippostrongylus braziliensis in Rats

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Community Paramedicine in Rural Areas: State and Local Findings and the Role of the State Flex Program (Policy Brief #35)

This study examined the evidence base for community paramedicine in rural communities, the role of community paramedics in rural healthcare delivery systems, the challenges faced by states in implementing community paramedicine programs, and the role of the state Flex programs in supporting development of community paramedicine programs. Additionally, the study provides a snapshot of community paramedicine programs currently being developed and/or implemented in rural areas. Another FMT briefing paper describes these same findings in detail. Highlights: Many rural community paramedicine programs are in pilot stages. Most community paramedics work within an expanded role rather than an expanded scope of practice, the latter requiring legislative or regulatory change. Funding and reimbursement for community paramedicine services are major challenges for the sustainability of community paramedicine programs. Data collection is vital for community paramedicine programs to be able to show value, including shared saving and patient outcomes. Collaboration at local and state levels is essential for buy-in, and partnering with the State Office of Rural Health is especially helpful in the early development and outreach efforts for rural community paramedicine programs

Evaluating the Needs of Cancer Survivors through Focus Groups and Surveillance Data

Introduction As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum. Methods Using data compiled from the Michigan cancer registry, the Michigan Behavioral Risk Factor Survey (MiBRFS), and focus groups, several areas of need amongst cancer survivors were identified. The cancer registry provides information on incidence and survival rates to help understand the burden of cancer; this Quantitative data from the Michigan cancer registry and MiBRFS can supplement the qualitative data gained from the focus groups. Results In focus groups cancer survivors identified the 27 needs that fell into three categories: improving health-related behavior, utilizing health care services, and receiving emotional support. The MiBRFS provided population estimates for 10 of the 27 needs that were identified by the survivors. Conclusions As the cancer survival rate increases, providers and public health workers must implement and promote services that provide care to patients from diagnosis to post-treatment. A population surveillance system, in conjunction with focus groups, can shed light on the exact needs that must be addressed. Surveillance data can demonstrate the impact of public health interventions, like tobacco cessation policies and system change projects, which ultimately impact the health and quality of life of cancer survivors

Improving Evaluation and Follow-up of Patients Diagnosed with Left Bundle Branch Block

Left bundle branch block (LBBB) is a pathologic finding on electrocardiogram (ECG). Most commonly present in patients with antecedent hypertension, cardiac enlargement, coronary artery disease or a combination of these Class 1B recommendation: Those with findings of LBBB on ECG should undergo transthoracic echocardiography for evaluation of underlying heart disease LBBB is prevalent (33%) in patients with heart failure Cardiac resynchronization therapy can improve left ventricular mechanical function in patients with LBBB (QRS \u3e150 msec) This study aims to understand how effectively we are evaluating and following up these patients at Thomas Jefferson University Hospital