Junior Faculty Investigator Award

 

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2009-2010

Rajat Deo, MD
Assistant Professor, Medicine, Division of Cardiovascular Medicine

A Comparison of Risk Factors for Cardiovascular Death and Sudden Cardiac Death Using a Competing Risk Analysis in Women

Project Abstract: Sudden cardiac death is an important clinical and public health problem that is highly specific for arrhythmic events including spontaneous ventricular tachycardia or ventricular fibrillation.  Cardiovascular death events, however, are often preceded by premonitory, cardiopulmonary symptoms and can be the consequence of long-standing coronary heart disease or congestive heart failure.  We proposed to compare risk factors for sudden cardiac death to those of non-sudden cardiovascular death among women enrolled in the Hormone and Estrogen Replacement Study. The HERS trial was a randomized, placebo-controlled trial that evaluated the effect of hormone replacement therapy on women with coronary heart disease.  Our project proposed to utilize a series of steps to evaluate the competing risk of sudden cardiac death and non-sudden cardiovascular death events in this population. We will first use a Dox proportional hazards model to evaluate the independent association of baseline demographics and time-dependent covariates with sudden cardiac death and non-sudden cardiac death, censoring follow-up at other kinds of death. We will then compare the strength of associations of baseline and time-dependent risk factors with each of these outcomes. Finally, we will estimate the competing risk cumulative incidence of sudden cardiac death and non-sudden cardiac death.  This method estimates cumulative incidence of first events without attempting to remove other causes of death.  Finally, we will compare the effects of baseline and time-dependent covariates on cumulative incidence of sudden cardiac death, non-sudden cardiac death, and death from other causes, all considered as competing risks.

Yi Jin, PhD, MS
Research Assistant Professor, Pharmacology

Cardiovascular Effects of Progestins and Their Metabolites

Project Abstract: Progestins are commonly used in hormone therapy for women, e.g., contraceptives and hormone replacement therapy. Progestins exert diverse effects on cardiovascular systems, and the mechanism of which is not well understood.  The natural progestin progesterone is believed to have beneficial cardiovascular effects, whereas the synthetic progestins are either neutral or harmful.  Women using contraceptives and hormone replacement therapy are subject to potentially long term harmful cardiovascular effects, thus, the understanding of the molecular mechanism of progestin effects is of paramount importance.  Exogenous progestins undergo extensive metabolism to form a variety of metabolites that may have diverse activities towards hormone receptors.  The activities of the metabolites on cardiovascular system are largely unexplored.  We hypothesize that progestin metabolites have regulatory cardiovascular functions that have been attributed to the parent progestin.  Herein, pilot studies are proposed to (1) determine the vascular metabolism of progesterone and in vitro metabolism of two representative synthetic progestins; (2) characterize the activities of progesterone and its metabolites to trans-activate different hormone receptors; and (3) examine the direct effects of progesterone and its metabolites on vascular function. The results of these studies will lay the foundation and test feasibility for the investigation of the identities and availabilities of progestin metabolites in vascular system and their receptor binding properties and cardiovascular effects.  The finding of this research will impact directly on the use and design of hormone therapy and help define new strategies to improve cardiovascular health of women.

Lilie Lin, MD
Assistant Professor, Radiation Oncology

Reducing Cardiac Morbidity for Women with Left Sided Breast Cancer: The Potential of Proton Radiotherapy

Project Abstract: Breast cancer is the second leading cause of cancer related mortality and is the most common non-skin cancer in women.  Surgery is the mainstay of treatment, however, postoperative breast or chest wall radiotherapy and chemotherapy are routinely given in both early and locally advanced breast cancer.  Cardiac morbidity is a well known late effect of therapy – both chemotherapy and radiation therapy.  Radiation techniques to minimize cardiac damage have been studied.  However, many of these studies were done in women with early stage breast cancer who do not require nodal irradiation. If patients require radiation of regional lymphatics, radiation fields are expanded potentially resulting in increased dose to surrounding normal tissues.  Improvements in normal tissue sparing may be accomplished with proton therapy which has physical advantages over photon beam therapy.  The aims of this study are: 1) To quantify the dose to the left ventricle, whole heart, and coronary vessels with standard three dimensional conformal radiotherapy using cardiac MRI. 2) To determine the impact of intrafraction motion on dose to the whole heart, left ventricle, and coronary vessels from either photon or proton beam therapy and to identify the optimal point in the respiratory cycle where dose to the myocardium and left ventricle is minimized. 3) To perform a comparative analysis of dose deposition to the left ventricle, whole heart, and main coronary arteries as identified on cardiac gated MRI using intensity modulated radiotherapy, 3D conformal radiotherapy, and scanning proton beam therapy for women receiving left breast or chest wall radiotherapy.

2008-2009

Hillary R. Bogner, MD, MSCE
Assistant Professor, Family Medicine and Community Health

Integrating Hypertension and Depression Management Among Older Women

Project Abstract: Older women experience a disproportionate burden of hypertension and depression.  Despite the importance and prevalence of hypertension, control tends to be poor among older adult women.  Poor adherence to medications for the treatment of hypertension and depression remains a significant impediment to improving care.  Depression contributes to poor adherence to treatment recommendations.  An integrated intervention addressing depression and hypertension in primary care would improve outcomes for both conditions and would be feasible in real world practices with competing demands for limited resources.  The aims of this study are to: (1) To determine if an integrated intervention strategy focused on improving adherence among women aged 50 years and older with clinically significant depression and hypertension results in improved (a) adherence to antihypertensive medications (b) adherence to antidepressants (c) blood pressure control and (d) depression remission and response over a 3 month interval. We will carry out a randomized controlled trial of the Integrated Care Intervention versus Usual Care.  Key components of the Integrated Care Intervention are: (a) provision of an individualized program to improve adherence that recognizes women’s social and cultural context; and (b) integration of hypertension and depression management.  Factors affecting adherence will be addressed using a 4-step problem solving process.  Our work should foster the development of integrated interventions for cardiovascular disease and depression.

Bonnie Ky, MD
Instructor, Medicine
Division of Cardiovascular Medicine

The Role of Circulating Neuregulin in Trastuzumab-Induced Cardiomyopathy

Project Abstract: Significant advances have been made in the treatment options for breast cancer, but cardiac toxicity associated with chemotherapy remains a critically important issue.  More than 20% of breast carcinomas overexpress the HER2/neu (ErbB2) gene and are thus particularly responsive to trastuzumab (Herceptin), a monoclonal antibody that binds to the extracellular domain of ErbB2.  However, a portion of these patients go on to develop significant cardiac dysfunction. The pathogenesis of trastuzumab-induced cardiomyopahty is still unclear.  Basic science evidence would suggest that trastuzumab-related cardiac damage may be related to the inhibition of the NRG/ErbB pathway in cardiomypcytes.  Animal studies have demonstrated a critical role for the neuregulin (NRG)/ErbB signaling pathway for fetal heart development and adult cardiac function.  NRG-1 activates the ErbB signaling pathway, and promotes the growth and survival of cardiomyocytes.  NRG-1/ErbB deficient animals develop a dilated cardiomyopathy phenotype, increased susceptibility to cardiac injury, and decreased survival.  However, whether these findings translate to humans are unknown. The overall objective of this proposal is to define the biologic and clinical relevance of circulating neuregulin as it relates to the risk of developing trastuzumab-induced cardiomyopathy.  We have preliminary evidence that neuregulin-1β (NRG-1β) levels are significantly decreased in subjects with chemotherapy-induced heart failure.  We will extend these findings by defining the association between levels of NRG-1β and risk of cardiac dysfunction in a cohort of patients who receive trastuzumab therapy.  Our study will provide important insight into the role of NRG-1β in chemotherapy-induced cardiomyopathy and its potential clinical utility as a prognostic tool.

Sindhu K. Srinivas, MD, MSCE
Assistant Professor, Obstetrics and Gynecology

Evaluating Short Term Cardiovascular Risk after Preeclampsia in African American Women

Project Abstract: Cardiovascular disease (CVD) is the leading cause of death in women, both in the United States and worldwide.  Recent studies suggest that hypertensive disease of pregnancy (gestational hypertension or preeclampsia) is associated with future cardiovascular morbidity and death. Given their retrospective nature, these studies are unable to identify when these women begin to incur increased risk for CVD. Preeclampsia is a pregnancy-specific syndrome broadly defined as the presence of hypertension and proteinuria.  It is a major contributor to maternal and perinatal morbidity worldwide.  Despite continued research to understand the underlying mechanisms responsible for the development of preeclampsia, the only known treatment is delivery. It has been difficult to identify women at-risk for CVD early and the observed association between preeclampsia and CVD provides a tremendous opportunity to determine when and if lifestyle modification and/or medical intervention may prevent significant cardiovascular morbidity and mortality.  If preeclampsia is an early manifestation of cardiovascular disease, identifying the time period at which these women have an increased risk and targeting this group at an earlier age might have a significant impact on long-term cardiovascular morbidity and mortality. Unique to this study will be a cardiovascular risk evaluation (components of the metabolic syndrome in non-pregnant African American women, 1-4 years from delivery, with a history of hypertensive disease in pregnancy and those without this history.  African American women are the subjects of this proposal since these women are disproportionately affected by both preeclampsia and CVD.  We hypothesize that African American women with a history of preeclampsia will have a higher prevalence of objective cardiovascular risk factors shortly after delivery.  This will enable future targeted early prevention/intervention trials in women at risk for future CVD to ensue.

2008-2009 (special cycle)

Najjia N. Mahmoud, MD
Assistant Professor, Surgery
Division of Colorectal Surgery

The Influence of Gender on Colorectal Surgical Outcomes and Operative Decision-making

Project Abstract: The purpose of this study is to examine gender-related issues specific to the surgical treatment of colon and rectal cancer. There is evidence to suggest that, although the disease strikes men and women in equal numbers, sugical planning, intraoperative decision-making, and functional outcomes may differ greatly between genders. Differences in anatomy, preoperative function, and referral patterns may affect outcomes ranging from local recurrence rates and anal sphincter preservation to survival. Differences in type of institution (university versus community hospital, for example), surgery specialty training, hospital surgical volume, hospital setting, and region may affect outcomes between genders, but very little is known about this to date. There is data demonstrating that rates of screening colonoscopy, although increasing in recent years for both men and women, lag behind in female patients nationally, and that far fewer African American and Hispanic women are referred for screening. We propose to investigate the question of whether these disparities also extend to differences in technically complex procedures such as colectomy and proctectomy, and to the complicated preoperative and postoperative medical decision-making that accompanies treatment. The SEER-Medicare database brings together Medicare administrative claims data with detailed clinical tumor registry data. We propose the use of SEER-Medicare date to answer these questions.

2007-2008

Zachary F. Meisel, MD, MPH
Assistant Professor, Emergency Medicine

Impact of Gender on Prehospital Management of Chest Pain

Project Abstract: Gender disparities in cardiac care have been demonstrated in emergency department (ED), in-hospital, and outpatient care. However, the impact of gender on the out-of-hospital evaluation and management of patients with chest pain who are in route to the hospital has not been studied. The identification of the nature and extent of prehospital gaps in quality of cardiovascular care for women has specific relevance because of the time-sensitive nature of cardiac syndromes and the influence that prehospital evaluation and treatment has on hospital-based care. We propose to conduct a retrospective cohort study that will seek to identify gender disparities in the out-of-hospital care of chest pain patients brought to two urban hospitals by a city-run emergency medical services (EMS) system. We will compare the prehospital use of therapeutic and diagnostic interventions, which have been proven to improve outcomes in cardiovascular syndromes, for male and female patients with chest pain.

Suman Lata Sood, MD
Instructor, Medicine, Division of Hematology/Oncology

A Phase II, Randomized, Double-Blind, Placebo-Controlled Feasibility Study of the Effects of Statin Use on the Coagulation System in Women with Metastatic Breast Cancer

Project Abstract: Venous thromboembolic disease (VTE) is a serious and potentially fatal disorder that especially affects the oncology population. Statins are widely used medications that have been shown to be safe in a number of settings. Interesting preclinical data exists which suggests that statins may decrease the risk of thrombogenesis by decreasing platelet activation, promoting fibrinolytic pathways, and down regulating the coagulation cascade. Several observational studies have demonstrated an association of statins with reduced risk of VTE, and that this association may be stronger in women than in men. It would be of great benefit to develop an non-anticoagulant strategy of VTE prophylaxis for metastatic breast cancer patients, who are at increased risk of developing venous thromboembolism and not tolerating anticoagulation, especially during active treatment with chemotherapy or hormonal therapy. As a first step in examining the potential clinical intervention, a phase II randomized, double blind, placebo controlled study is proposed to assess the feasibility of studying the effect of statin use on the coagulation system in patients with metastatic breast cancer. Sixty women with metastatic breast cancer undergoing chemotherapy and sixty women with metastatic breast cancer under treatment with hormonal therapy will be enrolled in the trial. Subjects in the chemotherapy and hormonal therapy groups will be randomized to either the placebo or the statin arm. Baseline coagulation markers will be drawn and then re-evaluated at the end of 12 weeks. Feasibility criteria will be assessed as the primary study endpoint.

Alexis A. Topjian, MD
Assistant Professor, Anesthesia, Critical Care

Association of Gender and Age with Survival Outcomes after In-Hospital Cardiac Arrest

Project Abstract: Survival outcomes after cardiac arrest are related to patient, facility and process of care factors. Pre-clinical studies suggest that estrogen is neuroprotective when administered before or immediately following cardiac arrest. Following human out-of-hospital cardiac arrest, female gender < 50 years of age is associated with better survival than age matched males. In-hospital cardiac arrest patients, process of care and outcomes are very different from the out-of-hospital setting. The relationship of gender and age to important process of care and survival outcomes following in-hospital cardiac arrest is unknown. Our objective is to determine the association of gender and age with in-hospital cardiac arrest event survival, with appropriate control for confounding patient and hospital characteristics. We will conduct a multivariable analysis using logistic regression of the world's largest cohort of in-hospital cardiac arrests, > 100,000 cardiac arrests reported by more than 350 hospitals to the American Heart Association's National Registry of CPR. We hypothesize that female gender is associated with better cardiac arrest survival outcomes than male gender, even when controlling for important patient, hospital and process of care factors. To further assess if presumed relative presence of estrogen (menarche/menopause) modifies the effect of gender on survival outcomes, we hypothesize that women of child-bearing age (13-50 years) will have better survival outcomes than girls <13 years (presumed pre-menarche) and women >50 years (presumed post-menopause) and age matched males. We expect the findings from this analysis to provide a springboard for future research, publications, collaborations, and grant proposals to address gender-relevant interventions that have promise to improve outcomes following cardiac arrest.

2006-2007

Angela M. Mills, MD
Assistant Professor, Emergency Medicine

A Randomized trial of an ED Tobacco Cessation Intervention with Parenting Women

Project Abstract: Tobacco is the leading cause of preventable death in the US, and exposure to passive smoke is a leading cause of morbidity and mortality in children. While 21% of Americans smoke, ED patients have a much higher rate of 40%. Approximately 40% of children who present to EDs live in households with caregivers who smoke. As many patients use the ED as their primary source of healthcare, the ED may be their only source for tobacco cessation information. While 50-60% of ED patients are asked about smoking, only 6-9% are counseled in cessation. Interventions in the ED may occur during "teachable moments," and a higher percentage of patients will quit if the reason for visit is related to their smoking.

We hypothesize mothers of young children may be more motivated to quit smoking if given a brief motivational interview (BMI) in an ED setting tailored to the effects of tobacco smoke on their own and their children's health.

The principal investigator will collaborate with the transdisciplinary Tobacco Use Research Center to develop and test a BMI tailored to parenting female smokers with young children. Patients will be randomized to BMI with Quitline card (smoking cessation hotline) and one-week follow-up phone call. The control group will be advised to quit and given the Quitline card. Both groups will be compared at one month with regard to stage of readiness to change, steps taken to reduce tobacco consumption, and successful quit rates, measured by self-report and a biological marker of nicotine use.

2005-2006

Susan A. Colilla, PhD, MPH
Instructor of Epidemiology in Biostatistics
and Epidemiology

Estrogen Metabolism Gene Polymorphisms
as Independent Risk Factors for
Cardiovascular Disease in Women

Project Abstract: Heart disease is uncommon in premenopausal women, but the risk increases dramatically after menopause, and it is likely due to the loss of the protective effects of estrogen. Surprisingly, exogenous hormone replacement therapy in postmenopausal women has not shown the expected beneficial cardioprotective results. Estrogens have favorable effects on lipids, endothelial function and remodeling but recent studies have suggested that some of the cardiovascular effects of estrogen may be attributed to intracellular estradiol metabolites. We hypothesize that polymorphisms in estrogen metabolism genes will have an independent effect on cardiovascular risk factors and cardiovascular outcomes and in part may explain the variable effects of estrogen replacement therapy.

Data from randomly selected control subjects participating in a recently completed population-based case-control study for breast and endometrial cancer in women will be tested for an association between estrogen metabolism gene polymorphisms and cardiovascular disease risk factors. We will also examine if estrogen metabolism gene polymorphisms can independently predict a cardiovascular disease outcome in these women. The goal will be to generate and streamline etiologic hypotheses about the relationship of estrogen metabolism gene polymorphisms, environmental factors and cardiovascular disease. This pilot project will focus the specific aims and provide preliminary data for an NIH grant proposal examining the relationship between estrogen levels, estrogen metabolism genes, environmental factors and heart disease in a current cohort study (SWAN) of perimenopausal women.

Darren Taichman, MD, PhD
Assistant Professor of Medicine
in Pulmonary, Allergy and Critical Care Division

Serotonin Activity and Cognitive Deficits
in Patients with Pulmonary Arterial Hypertension

Project Abstract: Pulmonary arterial hypertension (PAH) predominantly affects young women, causing progressive functional impairment, cardiopulmonary failure and premature death. While recent advances in therapy have increased survival, these women continue to suffer with significant limitations in exercise capacity. Further, disease effects beyond the cardiovascular system impose additional burdens on quality of life. The effects of PAH beyond the cardiovascular system, however, have not been well studied particularly the effects on brain function. We have recently developed a simple research tool for the identification of cognitive dysfunction in patients with PAH, and have shown that over half of patients tested have clinically significant cognitive impairments. Emerging data suggests that abnormalities in serotonin signaling might be important in the development of PAH as well as cognitive dysfunction. We therefore propose to evaluate the association of cognitive deficits dysfunction. We therefore propose to evaluate the association of cognitive deficits with abnormal serotonin signaling by determining:

  1. The prevalence of cognitive deficits in patients with PAH.
  2. Plasma serotonin transporter activity among PAH patients with and without cognitive deficits.
  3. The relationship between serotonin transporter activity and the presence of cognitive deficits in patients with PAH.

2003-2004

Marna S. Barrett, PhD
Assistant Professor of Psychology in Psychiatry

Engagement and Attrition in Community Mental Health Settings

Project Aim: Relying on established partnerships with two community mental health centers, the proposed study is designed to assess and document those factors most predictive of dropout for female consumers of public mental health services. Factors influencing engagement and attrition will be examined at several points during the initiation of services as well as examining the relation between attrition and mental distress. The purpose of this initial investigation is for understanding attrition patterns and their correlates; designing interventions to improve service utilization; and, providing the most effective treatment in the most efficient manner.

2003-2004

Harold I. Litt, MD, PhD
Assistant Professor of Radiology

Gender Differences in Imaging Evaluation of Patients
Suspected of Having Pulmonary Embolism

Project Aim: This project will expand on a preliminary study that determined marked gender differences in the utilization of Computed Tomography examinations performed for suspected pulmonary embolism of patients seen in the Emergency Department at HUP. This next phase of the project will investigate the usage of V/Q scans. Through an analysis of ED records, this study will attempt to determine which clinical factors, such as chief complaint, previous medical history, EKG findings, or other, may be contributing to this gender difference in utilization of diagnostic imaging studies. The goal is to foster more appropriate resource utilization as well as improved care for women suspected of having pulmonary embolism.

2003

Marina Catallozzi, MD
Instructor, Pediatrics

Relationship Choices of Adolescent Women:
Characterizing the Phenomenon of Older Partners

Project Aim: This preliminary study will explore the prevalence of young women having sex with older men and will begin to identify reasons for, and factors associated with, this behavior. Increasing understanding of this phenomenon to assist with the development of policy initiatives regarding training curricula for health care providers as well as with appropriate interventions for adolescents who are at highest risk for negative outcomes associated with this behavior.

2003

Peter Foster Cronholm, MD
Instructor, Family Practice and Community Medicine

The Association between Low-Literacy and Exposure to Domestic Violence in Prenatal Patients

Project Aim: A cross sectional study to assess the association between literacy level and exposure to domestic violence in prenatal patients; and, a specific hypothesis that low literacy levels will be associated with higher levels of exposure to domestic violence in prenatal patients. Low literacy and DV are associated with low self-efficacy. Interventions targeting variables that mediate self-efficacy may reduce adverse outcomes associated with DV.

2002-2003

Evaline A. Alessandrini, MD, MSCE
Assistant Professor, Pediatrics and Epidemiology

“Caring for Kids: Illnesses and Injuries”- A Community Intervention

Project Aim: Project motivated by the frequency with which impoverished mothers rely on emergency departments as the usual source of health care for their children.

  1. To examine the effects of a community-based education and skills intervention on maternal knowledge of common childhood illness and skills and confidence in caring for their children
  2. To examine the effects of a community-based education and skills intervention on the use of health (particularly emergency) services by children of mothers involved in this project.

2001-2002

Elizabeth Datner, MD
Assistant Professor, Emergency Medicine
Evaluating Emergency Department Services

Provided to Women Reporting Domestic Violence

Project Aim: To implement a clearly defined, routine intervention strategy in the Emergency Department at the Hospital of the University of Pennsylvania in cases of women patients who report being in abusive relationships; and, to use the transtheoretical Model of Behavioral Change to evaluate the effectiveness of physician-based intervention.

2000-2001

Carmen Guerra, MD
Assistant Professor, Medicine
Division of General Internal Medicine

The Association between Literacy and the Knowledge, Attitudes, and Behavior about Screening Mammography in Urban Hispanic Women

Project Aim: To determine whether functional health literacy:

  1. correlates with knowledge about screening mammography
  2. correlates with more negative attitudes about screening mammography
  3. is an independent predictor of poor compliance with screening mammography as determined by self-report

2000-2001

Catherine S. Bradley, MD
Instructor, Obstetrics & Gynecology
Fellow, Urogynecology and Reconstructive Pelvic Surgery

Female Urinary Incontinence: Developing and Pilot Testing a Diagnostic Questionnaire

Project Aim: To develop and pilot test a diagnostic symptom questionnaire, which can accurately classify women into the most common types of female urinary incontinence.

2000-2001

Jennifer Tjia, MD
Instructor, Medicine
Fellow, Division of General Internal Medicine

The Use of Tamoxifen for Breast Cancer Prevention: Assessing the Preferences of Minority and Older Women

Project Aim: To obtain data about the extent and determinants of interest in Tamoxifen use for breast cancer prevention by older, lower income, and minority women.

1999-2000

Judd E. Hollander, MD
Associate Professor, Emergency Medicine

The Effect of Written Informed Consent on Domestic Violence Screening

Project Aim: To determine whether the use of informed consent biases the results of standardized domestic violence screening assessments in the ED; to compare written versus verbal consent with the prediction that written consent is less efficacious in detecting domestic violence.

1999-2000

Raquel M. Schears, MD, MPH
Assistant Professor, Emergency Medicine

Gender Bias in Resuscitation Practices

Project Aim: To determine whether gender bias exists in resuscitation practices used for victims of non-traumatic cardiac arrest.

1999-2000

Sally Yael Segel, MD
Fellow in Maternal Fetal Medicine, Obstetrics and Gynecology

Duration of Antibiotic Therapy after Pre-term Premature Rupture of Fetal Membranes

Project Aim: To determine if the duration of Ampicillin therapy affects the ability of a woman with PPROM to achieve a seven day latency period from rupture of fetal membranes to delivery.

1999-2000

Joseph Bernstein, MD
Assistant Professor, Orthopedic Surgery

Patient Preference for Outcome: The Role of Gender in the treatment Threshold for Meniscal Tears

Project Aim: To assess gender differences in patient attitudes toward potential treatment outcomes for suspected meniscal tears of the knee.

1999-2000

Allan Gottschalk, MD, PhD
Assistant Professor, Anesthesia

The Impact of Preemptive Analgesia on Pain and Recovery from Major Surgery in Women: Pilot Studies

Project Aim: To obtain pilot data to support a future NIH study focused on gender differences in acute pain therapy by examining the gender variations in impact of preemptive analgesic methods in post-operative pain.

1999-2000

James M. Nicholson, MD
Clinical Instructor and OB Coordinator
Family Practice and Community Medicine

AMOR-IPAT: The Active Management of Risk in Pregnancy at Term: A Prospective Multidisciplinary Pilot Study of Nulliparous Pregnancy

Project Aim: To assess the feasibility of a randomized control trial of the Active Management of Risk in Pregnancy at Term (AMOR-IPAT) protocol, which aims to reduce cesarean section, rates in high-risk pregnancies.

1998-1999

Susan Gennaro DSN, RN, FAAN
Associate Professor, School of Nursing

Project Aim: To compare health outcomes in mothers of term and preterm infants. Controlling for parity, race, age, comparisons were made of two groups of mothers for the first four postpartum months.

1998-1999

Emma J. Brown, PhD, RN, CS
Research Assistant Professor and Coordinator
Center for Urban Health Research
School of Nursing

Barriers to Preventive Health and Primary Care Services for Women Who Use Crack Cocaine

Project Aim: To identify retrospectively the barriers to preventive and primary health care faced by women who use crack cocaine; to describe and classify these structural, financial, and personal barriers; to identify sources of primary care readily available to these women, sources that will then provide ongoing health services to the study sample; to monitor prospectively the women’s patterns of using these preventive and primary-care services after barriers have been reduced or eliminated.

1997-1998

Elizabeth Datner, MD
Assistant Professor, Emergency Medicine

Utilization of the Emergency Medical/911 System as an Identifier of Domestic Violence

Project Aim: To yield important data on the potential for the EMS/911 system to be used to reach out to women at risk of domestic violence- identifying what reasons the domestic violence victims gave for calling 911, as compared to reasons given by non-victims, thereby developing preliminary indicators for future intervention.

1997-1998

Anne Blackwood, MD
Instructor, Medicine
Hematology-Oncology Division
Senior Scholar, Center for Clinical Epidemiology and Biostatistics

Dr. Blackwood's areas of research interest are molecular epidemiology and cancer genetics, specifically in the development of risk prediction methodologies and preventive interventions in the hereditary breast cancer population.

Modifiers of Breast Canter Risk among BRCA1 Mutation Carriers: Polygene Interactions

Project Aim: To investigate hypotheses related to the modification of breast cancer penetrance among BRCA1 mutation carriers. The risk modifiers being investigated include reproductive factors and the genotypes of several carcinogen-metabolizing genes. This study also investigates possible interactions between these carcinogen-metabolizing genotypes and reproductive factors in modifying breast cancer penetrance among BRCA1 mutation carriers.

1996-1997

Annie Steinberg, MD
Assistant Professor, Departments of Psychiatry and Pediatrics
Director, Deafness and Family Communication Center, CSH of CHOP

Lip reading in the Stirrups

Project Aim: Through a series of focus groups, to address deaf women experiences, perceptions, attitudes, and beliefs about their health and health care experiences.

1995-1996

Joan Von Feldt, MD
Assistant Professor, Medicine
Rheumatology Division

Project Aim: To evaluate the use of an abbreviated cognitive screen which can be used in a practitioner's office to identify and evaluate cognitive dysfunction in a cohort of women with Systemic Lupus Erythematosus (SLE), an illness that more commonly affects women of minority status. The screen has the potential to become a useful tool to follow a patient's clinical response to therapeutic interventions.

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