Cognitive Assessment and Aging Physicians: Are Patients or Doctors the Ones at Risk?

February 5, 2016: The aging of our physician workforce presents a new concern for both workers and patients. Cognitive changes associated with aging can impact clinician performance. In some cases, cognitive aging progresses beyond acceptable age-associated changes into the realm of pathological aging with clinically significant performance consequences. This presentation will describe normative cognitive aging and how this impacts physician performance. We will also discuss the evolving approaches to evaluation of physicians with suspected cognitive impairment and the implications that these evaluations have for patient safety, clinician privacy, and institutional risk management.

Dr. Ellison is the Swank Foundation Endowed Chair in Memory Care and Geriatrics at Christiana Care Health System. As director of McLean Hospital's Memory Diagnostic Clinic, he has consulted on physicians and other professionals seeking to differentiate normal cognitive aging from early cognitive impairment of clinical significance. He has assessed and treated physicians responding to institutional concerns about cognitive performance as a consultant to the Massachusetts Medical Society's Physicians Health Service. Dr. Ellison has published on Mild Cognitive Impairment and has lectured on physician performance and cognitive aging.

Video

What CAN be done about the Cost of Care for Chronic Diseases and Conditions

January 22, 2016: The annual cost of care in the United States for people with chronic diseases accounts for more that 83 percent ($1.2 trillion) of all healthcare costs – and this cost continues to rise. Yet many chronic diseases and conditions are linked to lifestyle choices so they can be prevented. This presentation will review the current trends in these healthcare costs and the characteristics – some of which are controversial - of efforts to reverse the trend. 

Dr. Stanhope joined the University of Delaware in 2007 after retiring from the National Institutes of Health where he served as a Senior Scientist. He currently serves as the Associate Deputy Provost for Research and Scholarship. As Director of the Delaware INBRE, Dr. Stanhope leads this effort to advance Delaware’s biomedical research capability. Dr. Stanhope also directs the BADER Consortium which partners with military treatment facilities and the VA to help wounded warriors and civilians with traumatic limb injuries and loss reach their optimal level of function.

Video

Assembling and Analyzing Cohorts from Electronic Health Records: An Example from the NICU

January 15, 2016: Electronic health records (EHR) contain a wealth of information potentially useful for public health research, and can be used to assemble retrospective cohorts for epidemiological analyses. This presentation demonstrates the experience of the Neonatology Division of the Department of Pediatrics to create a research dataset from the neonatal intensive care unit (NICU) EHR.  We then examined yearly trends in the incidence of late onset sepsis, and its association with a high NICU census.

Neal D. Goldstein is a PhD-trained epidemiologist with academic and industry experience working with large data sources. His research spans several disciplines including vaccine-preventable infectious diseases, maternal and child health, and advanced epidemiological modeling. He also possesses a background in biomedical informatics with detailed knowledge of hardware and software in the healthcare domain. Most recently, he has focused on translational epidemiology, or moving from knowledge generation to application and advocacy.

Video

Applied Genomics: Next Generation Sequencing in the Clinical Field

January 8, 2016: Acute myeloid leukemia (AML) is a disease of the genome involving many genetic alterations for disease onset. Using next generation sequencing (NGS) data generated by the NCI TARGET project from pediatric AML patients, we have developed a novel pipeline for detection of SNVs and structural variants with enhanced data integration, visualization, and prioritization scoring to facilitate clinical understanding of the genetic data associated with the clinical phenotype. In a pilot study we analyzed six FLT3/ITD positive pediatric AML samples, with varying FLT3/ITD allelic ratios—and became the first group to detect the ITD sequence in NGS datasets previously only reported via PCR. A thorough analysis between the diagnosis and relapse sample has revealed several relapse-specific mutations. We have begun full-scale analysis of all TARGET AML whole genome and exome data from several hundred patients aiming to identify a pediatric AML specific diagnostic gene target list and relevant therapeutic genetic alterations.

Erin Crowgey is a PhD candidate at the University of Delaware, and is planning on joining Nemours Children’s Hospital as Associate Director of Bioinformatics in February of 2016. Her main area of research is pediatric AML, with a focus on analyzing and integrating next generation sequencing generated from ~800 AML patients.

Video

The Complex Network of Human Disease: Applying Network Theory to Medicine

December 4, 2015: Recent research has advanced a network-based approach to human disease based on the hypothesis that a disease phenotype is rarely a consequence of an abnormality in a single effector gene product, but reflects various pathobiological processes that interact in a complex network. Networks have been studied in mathematics, computer science, engineering and social sciences for decades, but this application to medicine is very new and brings together researchers in mathematics, computer science, statistics and medicine. This talk will present the basics of networks and an interpretation of some of the results in the area of network medicine.  

Dr. Sebastian Cioaba is Associate Professor in the Department of Mathematical Sciences at the University of Delaware's College of Health Sciences. His research is in graph theory and combinatorics.

Video

Privacy-Protecting Technologies for Collaborative Research

November 20, 2015: The rapid increase in digitized information related to human health has raised the possibility of performing more complex statistical analyses by pooling data from several different sources or institutions. This presentation will discuss modern approaches for sharing access to private data to give clinicians and researchers an overview of how these technologies work, what the current state-of-the-art is, and what the potential benefits and limitations may be. 

Dr. Anand D. Sarwate is an Assistant Professor of Electrical and Computer Engineering at Rutgers University. His work is at the intersection of statistics, computing, and signal analysis, and for the last 5 years he has worked actively on algorithms for machine learning and statistical analysis of private data.

Video

Fighting the Old Man's Friend: Improving Outcomes for Patients with Pneumonia

November 13, 2015: Community-acquired pneumonia remains one of the major causes of morbidity and mortality worldwide. Recent advances in diagnostics, therapeutics and preventive strategies may significantly improve outcomes from this illness. This presentation will explore recent advances in care for patients with pneumonia and strategies for implementing them. 

Dr. Joshua P. Metlay, is Professor of Medicine at Harvard Medical School and Chief, Division of General Internal Medicine at Massachusetts General Hospital.

Video

The State of Immunization: Understanding Law, Policy, and Resistance

November 6, 2015: Although the introduction of vaccines has been an enormous public health boon to many diseases, including the major childhood diseases, the possible eradication of these diseases has been compromised by the increasing number of parents and guardians who choose not to vaccinate their children. These decisions are enabled by legislation in most states that was enacted under Congressional pressure. While a few states, like California, have moved to make exemptions from routine vaccination requirements more difficult, most states still require deference to parental decisions based on religion or, more amorphously, on “philosophical” objections.

This presentation will discuss the recent history of exemptions, the clustering of disease in communities with high rates of vaccine refusal, and suggestions for changing the dialogue. Among the suggestions raised will be: increased public awareness of the Vaccine Injury Compensation Program; purposely separating discussion of vaccinations that protect against STDs; and agitating for legislation that achieves a compromise by requiring more of parents who wish to opt out of vaccinating their children. The possibility of imposing civil liability on parents whose children infect other children will also be discussed.

John G. Culhane, J.D., is the H. Albert Young Fellow in Constitutional Law, and Co-Director of the Family Health Law & Policy Institute at Delaware Law School (Widener University).

Video

Collaborations in Global Health: The Global Network for Women's & Children's Health Research

October 30, 2015: The collaborative research team of J N Medical College in India and Christiana Care Health System, Delaware, USA are part of the National Institute of Child Health and Human Development (NICHD) Global Network for Women's and Children's Health Research (GN). Over the past 5 years, the Belgaum site in India has implemented a population based Maternal and Newborn Health Registry for tracking pregnancy outcomes and monitoring mortality trends to inform development of community based interventions aimed at improving health outcomes of mothers and children. This presentation will provide an overview of the groundbreaking research from this Global Network field site within the broader context of global health research at Christiana Care.

Dr. Goudar is the Course Coordinator for the Postgraduate Diploma in Health Professions Education program offered by KLE University, Belgaum in collaboration with the University of Illinois at Chicago. Dr. Derman is the Marie E. Pinizzotto, M.D., Endowed Chair of Obstetrics and Gynecology at Christiana Care. Dr. Khan is Physician Leader for the Primary Care & Community Medicine Service Line and Medical Director for Community Health and the Eugene duPont Preventive Medicine & Rehabilitation Institute at Christiana Care.

Video

A Quantitative Model for Glagov Remodeling in Atherosclerosis

October 23, 2015: Glagov phenomenon describes how atherosclerotic vessels change shape under an increasing disease burden (see Glagov et al, New England Journal of Medicine 1987). Specifically, lumen areas remain constant or increase slightly before contracting as intima areas increase. This presentation will introduce a mathematical model for Glagov remodeling and allow clinicians and researchers to understand the process in terms of the elastic properties of the vessel.

Dr Pak-Wing Fok is an applied mathematician from the Department of Mathematical Sciences at the University of Delaware. He obtained his PhD from MIT in 2006 and from 2006-2009, held a Von Karman Instructorship at Caltech and a postdoctoral position in the Department of Biomathematics at UCLA. His research interests include mathematical biology, stochastic processes and operations research.

Video

Pages