Evaluating the implementation of a community health worker-delivered intervention integrating asthma care in West Philadelphia public schools.

OBJECTIVE: Schools are an important setting because students spend much of their time in school and engage in physical activity during the school day that could exacerbate asthma symptoms. Our objective is to understand the barriers and facilitators to implementing an experimental community health worker-delivered care coordination program for students with asthma within the context of the West Philadelphia Controls Asthma study. METHODS: Surveys (n = 256) and semi-structured interviews (n = 41) were completed with principals, teachers, nurses, and community health workers from 21 public and charter schools in West Philadelphia between January 2019 and September 2021. Survey participants completed the Evidence Based Practice Attitudes Scale, the Implementation Leadership Scale, and Organizational Climate Index. Semi-structured qualitative interview guides were developed, informed by the Consolidated Framework for Implementation Research. RESULTS: Participant responses indicate that they perceived benefits for schools and students related to the community health worker-based care coordination program. Several barriers and facilitators to implementing the program were noted, including challenges associated with incorporating the program into school nurse workflow, environmental triggers in the school environment, and challenges communicating with family members. An important facilitator that was identified was having supportive school administrators and staff who were engaged and saw the benefits of the program. CONCLUSIONS: This work can inform implementation planning for other locales interested in implementing community-based pediatric asthma control programs delivered by community health workers in schools.

Assessing Physicians' Recommendations for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Testing Among Minority Populations in Greater Philadelphia and New York City.

Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians' recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk.

Thomas Dent Mütter, M.D. (1811 to 1859): Exemplar of Expertise.

Thomas Dent Mütter, a Philadelphia plastic surgeon in the 1840s, boldly championed anesthesia when few physicians were convinced of its virtues. He was an early advocate of handwashing and hygienic wound care and helped pioneer the concept of postoperative recovery units. A leader in education, Mütter used a highly interactive style of teaching and restructured medical school classes to raise the caliber of clinical training. He supplemented his lectures with a myriad of specimens that he amassed over 24 yr. In 1863, this vast collection would serve as the basis for the Mütter Museum, which remains active today. Mütter exemplified expertise by tirelessly pursuing new knowledge and methods for the benefit of his patients and students.

The Linton A. Whitaker Legacy: Cultivating Craniofacial Surgeon Leaders.

BACKGROUND: Linton A. Whitaker is a pioneer of craniofacial surgery. He served as chief of plastic surgery at the Children's Hospital of Philadelphia and University of Pennsylvania and director of the craniofacial training program. Herein, the authors reflect on his legacy by studying the accomplishments of his trainees. METHODS: Dr Whitaker's trainees who completed (a) craniofacial fellowship training while he was director of the program or (b) residency training while he was chief were identified. Curricula vitae were reviewed. Variables analyzed included geographic locations, practice types, academic leadership positions, scholarly work, and bibliometric data. RESULTS: Between 1980 and 2011, 34 surgeons completed craniofacial fellowship training under Dr Whitaker, and 11 completed plastic surgery training under his chairmanship and subsequent craniofacial fellowship. The majority had active craniofacial practices after training (83.3%) and practice in an academic setting (78.0%). Most settled in the northeast (31.1%) and south (31.1%) but across 24 states nationally. Overall, the mean ± SD number of publications was 76 ± 81 (range, 2-339); book chapters, 23 ± 29 (0-135); H-index, 18 ± 12 (1-45); and grants, 13 ± 16 (0-66). Of those who pursued academia, 53.1% were promoted to full professor, 46.9% had a program director role, 75.0% directed a craniofacial program, and 53.1% achieved the rank of chief/chair. CONCLUSIONS: Equally important to Dr Whitaker's clinical contributions in plastic and craniofacial surgery is the development and success of his trainees who will undoubtedly continue the legacy of training the next generation of craniofacial surgeon leaders.

Angelo Chiavaro (1870-1944), the first "American style" Italian dentist.

Angelo Chiavaro (1870-1944) took his Medicine Degree at the University of Florence and then moved to the University of Philadelphia; he was the first Italian doctor to enroll and graduate from the Philadelphia Dental School, obtaining in 1899 the diploma of Doctor of Dental Surgery. In 1915, he was the first full professor of Dental Clinics in Rome; in 1923, he established a "National School of Dentistry" in Rome and his aim was to confer the first Italian degree in Dentistry and Dental Prosthetics following a University educational path similar to American schools.

Reuben Friedman (1892-1956): Dermatologist, historian, and scabies enthusiast.

Reuben Friedman was a prominent physician, scholar, and historian whose work contributed significantly to the development of modern dermatology. He was born into a Russian immigrant family in the Northern Liberties section of Philadelphia, where he established his family and later opened his medical office. He graduated from Temple University School of Medicine, completed his internship at Philadelphia General Hospital, and pursued further training abroad. During the height of his career, Friedman was affiliated with the Philadelphia Skin and Cancer Hospital and served as a faculty member at Temple University School of Medicine. He was recognized internationally for his extensive work on scabies, penning four books, several monographs, and various presentations on its etiology and treatment. His final book, History of Dermatology in Philadelphia, recollects the evolution of dermatology in Philadelphia and numerous biographies of protagonists in the field.

More than a thank you: the DAISY Award for Extraordinary Nurses.

The DAISY Award for Extraordinary Nurses was established to thank the nursing profession. This article describes the DAISY Award and its positive effects on retention at an urban hospital in Philadelphia.

PennDemic Simulation Framework: An Innovative Approach to Increase Student Interest and Confidence in Disasters Preparedness/Response and Interdisciplinary Teamwork.

An interdisciplinary group from two higher-education institutions in Philadelphia developed a novel framework for interprofessional education. This framework was applied to two different scenarios disease outbreak and natural disaster, which were used in simulations in 2018 and 2020. By design, these simulations included students from a broad range of disciplines, beyond the typical healthcare fields. Students were first grouped by discipline and were then placed in interdisciplinary teams for the rest of the scenario. Students were administered four surveys throughout which included 10 point-Likert scale and free response items. A statistically significant post-simulation increase in student interest and confidence was found. Survey analysis also revealed higher scores of positive group behaviors among interdisciplinary teams when compared to discipline groups. Importantly, students realized the importance of broad representation of disciplines for disaster preparedness. The PennDemic framework may be helpful for teams looking to develop simulations to build interest and confidence in disaster preparedness/response and interdisciplinary teamwork.

[The Gross Clinic--portrait of a pioneer]. / The Gross Clinic--portrett av en pioner.

THE GROSS CLINIC: is an 1875 painting by Thomas Eakins which is counted among the world's most famous doctor's portraits. This picture became more topical when it was sold to the Philadelphia Museum of Art for 68 million USD in 2006. We here present aspects of how this picture can help to document surgical practice in the USA at the time it was made. A comparison with a later doctor's portrait, THE AGNEW CLINIC: painted by Eakins in 1889, : shows that many changes occurred during a short time in the end of the 19 th century. This is especially the case within infection prevention, anaesthesia and development of the surgical profession as such. From an art historical perspective it has been common to compare the portrait with the old masters' group portraits of surgeons in surgical theatres. The most known of these is Rembrandt's DR. NICOLAES TULP'S ANATOMY LECTURE: (1632). In our opinion it is more interesting to consider THE GROSS CLINIC: in connection with concomitant photographies of medical practice. The realistic motive for the painting was assessed as inappropriate and unsuitable for a piece of art at the time. Despite of this, Eakins himself regarded the picture as one of his best, and during the 20 th century THE GROSS CLINIC: has been increasingly acknowledged. Today, the picture is the piece of art that Thomas Eakins is mainly associated with.

John Buchanan's Philadelphia Diploma Mill and the Rise of State Medical Boards.

The absence of medical licensing laws in most states during the years following the American Civil War made it possible for unscrupulous individuals to capitalize upon the weak governmental role in medical practice and educational charters. The practices of John Buchanan during much of his tenure at the Eclectic Medical College of Pennsylvania, in issuing thousands of dubiously earned diplomas, caused a national and international scandal. The traffic in diplomas became so flagrant that regulatory oversight of physicians and their practice, such as that conducted by the Illinois Board of Health led by Dr. John Rauch, developed rapidly across the United States. Though multiple factors prompted the rebirth of medical licensing laws, professional, educational, journalistic, and public concerns for bogus diplomas played an important role.

A physician/advanced practice nurse home visiting program.

The Visiting Nurse Association of Greater Philadelphia became the first home health agency in the United States to bill and collect physician and advanced practice nurse payments from Medicare Part B for services delivered in patients' homes. How does this program stay successful?