Primary Care for the Homeless and Formerly Homeless: A Community Based Quality Improvement Project for Health Professionals

No abstract available

A.R.C.H.E.S. - Community Health Symposium

No abstract available

Community Service and Public Health: The Jefferson Health System

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The interplay of obesity and asthma

The relationships, interactions, and association between obesity and asthma are complex, and are active sources of hypotheses and research. An association between obesity and asthma has been reported in many studies, although considerable debate about the existence of the association and its meaning still exists. Potential associative relationships may result from genetics, immune system modifications, and mechanical mechanisms. The rising prevalence of asthma and obesity in children and adults, and the significant morbidity from both, makes it imperative that clinicians recognize the importance of weight management in patients with and without asthma

A Comparison of Screening, Prevention, and Management for Hepatitis B Patients between the US and Chinese Healthcare Systems

Introduction: Hepatitis B (HBV) is a complex disease entity with potentially serious outcomes, including developing hepatocellular carcinoma (HCC). HBV is estimated to be responsible for about 50-80% of HCC cases worldwide, and 75-95% of HCC cases in HBV endemic regions.1 HBV and HCC are great concerns especially in East Asian countries like China. In China, HCC ranks as the 2nd most common cancer and 2nd in cancer mortality, both behind only lung cancer.1 China is considered an endemic HBV region, with about 100-150 million people infected. In comparison, only an estimated 550,000-2 million people are chronically infected in the US.2 With such high volumes of HBV and HCC cases in China, there are lots to be learned from how the Chinese healthcare system addresses this public health issue. Objective: The purpose of this study was to elucidate if there were any efficiencies or best practices the US healthcare system can adopt from how the Chinese healthcare system screens for and manages HBV. Methods: This qualitative study was done through primary research, including methods such as interviews, clinical shadowing, and photo-journaling. Key informant interviews (KIIs) were conducted with Jefferson hepatologists (N=2), to set a baseline understanding of how HBV patients are managed in the US. Similar KIIs were conducted with Chinese hepatologists (N=2), infectious disease physicians (N=1), and liver surgeons (N=2) at West China Hospital in Chengdu, China. Notes from 2 weeks of clinical shadowing were also included to provide additional understanding. Finally, a qualitative, cross-country comparison was done to uncover similarities and differences between the two countries with regards to how HBV patients are managed. Results: Pharmacologic treatment of HBV patients in China is very similar to that of the US. Antiviral therapies, such as entecavir and tenofovir, continue to be first-line treatments in both countries. Clinical management of HBV patients in China is also very similar to the US. In both countries, HBV patients are followed-up every 3-6 months, with routine labs (i.e. CBC, LFTs, viral load) and imaging (i.e. abdominal US) required. However, the most stark contrast between the two countries is the physician-patient relationship. Due to differences in patient volume and general population size, the Chinese healthcare system is much more focused on quantity of patients served rather than quality of services provided. Conclusion: The biggest difference in management of chronic HBV between US and China is how patients are treated. It’s typical for Chinese hepatologists to see 60-80 HBV cases per day (~5-7 minutes / patient), whereas US hepatologists see 5-15 cases per day. From clinical shadowing, it’s apparent that US hepatologists take much more time on patient education, whereas the Chinese hepatologists do not focus on this due to time constraints. Whether or not the closer doctor-patient relationship in the US translates to better disease outcomes is still an open question that warrants further studies. Because HBV is a bigger issue on a much larger scale in China, physicians, health officials, and the government have been trying to address this issue on a public health scale through national efforts to improve vaccination rates and HBV screenings

Partnerships for Health - Jeff HEALTH and the Rwanda Village Concept Project – A Model of Interdisciplinary Health Professions Student Global Education

A partnership between the Rwanda Village Concept Project (RVCP), a medical student program in Butare, and Jeff HEALTH (Helping East Africans Link to Health), a multidisciplinary student organization at ThomasJeffersonUniversity, has been working in two Rwandan villages for the past five years. Initially, The Rwanda Health and Healing Project consisted of two programs, a Genocide Survivors Village Transformation and creation of a GenocideMemorial Park. These programs lead to a comprehensive community health assessment, which: 1) documented the needs through key informant interviews and focus groups; 2) identified health resources currently available; and 3) reviewed needs in context of the social and political history of Rwanda. The partnership has grown and taken shape based on this assessment and students\u27 learning experiences. Medical, Nursing, Public Health and Occupational Therapy students have implemented programs in hygiene, malnutrition, HIV education, and malaria prevention. The Rwandan students monitor these programs monthly when the Jeff HEALTH students are stateside. The team partnered with the Mid-Atlantic Chapter of Engineers Without Borders in a latrine construction project. For each of the past 4 years, 3 Rwandan medical students have spent 2 months at Jefferson exploring community medicine as a discipline. A formal educational program and peer mentoring prepares Jeff HEALTH students for immersion into Rwandan projects. Based partially on the success of this model of collaboration and growing faculty and student interest,Jefferson has expanded its Global Health education initiatives to a 4-year longitudinal area of concentration in Population Health for medical students and a Certificate in Global Health in the MPH Program. Learning Objectives: Participants at the presentation will be able to: 1. Learn a method to develop a collaborative international health professional interdisciplinary student driven initiative 2. Identify strategies for sustaining programs through cooperative agreements between students at aUnited StatesAcademicHealthCenterand anEastAfricanMedicalSchool 3. Organize an interdisciplinary student global education program based on student experiences and interes

The Urban Health Penalty and Jefferson Health System\u27s Community Health Collaboration

No abstract available