Year In Review
2016
...to enhance the well-being of the community through education and the promotion of public health.
From the Academy/DPHA leadership.... One of the true privileges that the board and staff appreciate each time we produce the “Year in Review” is taking a look back at how much we were able to accomplish with our members and partners in the pursuit of our mission. While we are small in staff and associates, we have a deep and diverse collaborative community and membership that empowers us to accomplish much and a board of directors and advisory council who is deeply engaged in our work. This year’s publication is in a new format so that we can tell more of the story about what we’ve accomplished in the previous year, and include pictures which communicate so much more. On the cover, we highlight last year’s Lewis B. Flinn President’s Award winner – J. Kent Riegel, and the 2016 Public Health Recognition recipient – former Governor Jack Markell. Images of community engagement and education are shown, along with the winning submissions from our National Public Health Week photo contest. 2016 was a year of solidifying existing programs like the Immunization Coalition of Delaware with our partner, the Delaware Division of Public Health; mounting new programs like the Delaware Plan4Health partnership with the Delaware Chapter of the American Planning Association; joining the Christiana Care Value Institute’s staff on the “Partners in Research: CKD Engagement Project” a first ever in Delaware engagement award from PCORI. 2016 was also the year that we received two significant grants to support the role out and training program for the State’s new DMOST program. As always, we worked on several conferences, some uniquely our own, others in collaboration with partner institutions. Regardless, the goal is always the same: To keep our colleagues up-todate with the latest understanding of medicine and prevention. New in 2016 we invested in a an online learning management system to make CME available 24/7/365, rather than limit it to live activities. Delaware Mini Medical School continued its tradition of health education and literacy to our community, and we are deeply grateful for the partnership with the Christiana Care Health System that supports this program. In addition, our summer internship program engaged three exceptional individuals at an even deeper level as they pursue their careers in public health, history, and law. While 2016 had more than its share of turmoil in public health, healthcare, and politics – we say “thank you” to everyone who worked with us to change the trajectory of the health and wellbeing of our own neighbors here in the First State. These people are our authors, speakers, instructors, advocates, financial experts, and volunteers. At its core, the Academy is only as strong as those we engage and work with – and we are fortunate indeed. Yours in health and wellness,
Daniel J. Meara, MD, DMD President of the Board On the cover...
Omar A. Khan, MD, MHS President of the Advisory Council
Timothy E. Gibbs, MPH, NPMc Executive Director
From top left - Governor Jack Markell accepts the 2016 Public Health Recognition, community members meet at a Delaware Plan4Health session, Dr. Tabassum Salam at the podium, J. Kent Riegel accepts the Lewis B. Flinn President’s Award from Dr. Arun Malhotra, patient and caregiver engagement for the Chronic Kidney Disease project, presenters at Mini Medical School, two images from National Public Health Week (left - Sarah LaFave, and center - Kristen Neal), Dr. Claudine Jurkowitz, an audience in the John H. Ammon Medical Education Center, a group shot of a majority of the Academy Board of Directors at the annual meeting in 2016.
Delaware Journal of Public Health
In the fall of 2015 we welcomed colleagues, professionals, students, and members of the public health community to the first edition of the newly developed publication of the Delaware Academy of Medicine/Delaware Public Health Association. The Delaware Journal of Public Health is an electronic publication released on a bi-monthly basis. Our first year statistics exceeded expectations. On the issuu.com web platform, there were over 8,000 reads of the Journal, and over 130,036 impressions (each time the publication was displayed on social media or in an email). Additionally, the Journal has been directly accessed from our websites and Facebook over 1,300 times, and several readers are taking advantage of the “print-now” feature of the electronic document, and creating their own hardcopy. Equally gratifying are the 120 authors who have submitted outstanding content for the Journal to date. These authors have come from all sectors and walks of life — from researchers and clinicians, to patients and advocates. The Journal provides public health with a voice in the First State, and we are delighted that so many are engaging with us to share their experience, expertise, and point of view. Below, and on the following two pages, are covers of the Journal and its Tables of Contents. You can see that as time progressed, the amount of content in each ensuing Journal significantly increases in the October and December issues. The Journal is always freely available at djph.delamed.org.
January 2016 The discussion about End of Life is exceedingly complex, replete with countless acronyms and terms which are sometimes interchangable, but usually very specific in their meaning. This word cloud represents many of the words, abbreviations, and terms that are part of this issue.
Welcome from this Issue’s Guest Editor Kathleen W. McNicholas, MD, JD Interview with Susan Del Pesco, Esq Elizabeth E. Healy, MPH An Interview with Dr John Goodill Elizabeth E. Healy, MPH The Importance of Advance Health Planning Nathan Kottkamp, Esq The Increasing Importance of Advance Care Planning John Goodill, MD A Promise to Auntie Bini: Lessons From a ‘Work Around’ and the Value of DMOST Kathleen W. McNicholas, MD, JD Impact of DMOST on Hospice and End-of-Life Care Timothy Langan, MD and Keagen Brown, MBA, CPHIMS Delaware Medical Orders for Scope of Treatment Act: Keeping Control of Treatment Decisions Wade Scott, Esq The Evolution of Hospice Care: Expanding Access with the Concurrent Care for Children Provision Billie Winegard, MD, MPH and Wendy Sturtz, MD Glossary of Terms Staff Delaware Register of Regulations ‘State of Public Health 2016’ with CDC Director Tom Frieden, MD, MPH Daniel Greenberg From the History and Archives Collection Timothy E. Gibbs, MPH, NPMc
P R O V I D I N G A V O I C E A N D P L AT F O R M
The peer-review publication dedicated to public health in Delaware.
P R O V I D I N G A V O I C E A N D P L AT F O R M
April 2016 Volume 2 | Issue 2
Delaware Journal of
Public Health A publication of the Delaware Academy of Medicine / Delaware Public Health Association
Welcome from this Issue’s Guest Editor Awele N. Maduka-Ezeh, MD, MPH
Zika Virus—An Obscure Disease Goes “Viral” Awele N. Maduka-Ezeh, MD, MPH
An Interview with Alfred E. Bacon, III, MD Elizabeth E. Healy, MPH
Delaware Programs Combat Teen STI Rates with Education, Resources Christopher C. Moore, BA, LSSGB
A Model of Comprehensive HIV Care: Christiana Care HIV Program Arlene Bincsik, RN, MS, CCRC, ACRN; Deborah Kahal MD, MPH & Susan Szabo, MD
Viral Hepatitis C and Its Distribution in Delaware Nhiem Luong, MD, DrPH; Martin Luta, MD; Cathy Mosley, BSN & Jon Hildick-Smith
Syphilis Stephen C. Eppes, MD
Gonorrhea Stephen C. Eppes, MD
Sexually Transmitted Infections
*
Zika Virus An Obscure Disease Goes “Viral” page 6
Increasing Adolescent STI Screening in Delaware School-Based Health Centers
Interview with Alfred E. Bacon, III, MD page 10
Ruth Lytle-Barnaby, MSW, CEO and President of Planned Parenthood Delaware
Increasing Adolescent STI Screening in Delaware School-Based Health Centers
page 32
www.delamed.org | www.delawarepha.org
Sexually Transmitted Diseases: An Overview
Kay McLean-Grant, RN, MSN, CPNP; Martha Coppage-Lawrence, RN, MSN, CPNP & Mary Stephens, MD, MPH
April 2016
The DPH Bulletin
Although sexually transmitted infections are largely preventable, they continue to impose burdens such as high costs and complications, and remain a significant public health issue. The enclosed circle backslash signifies that by increasing awareness and prevention of STIs, we can reduce the resulting irreversible complications and long-term health problems, and improve reproductive health in the community.
June 2016 Volume 2 | Issue 3
Delaware Journal of
Public Health A publication of the Delaware Academy of Medicine / Delaware Public Health Association
Delaware Division of Public Health
Declining HPV Vaccination Rates in Delaware: Cause for Concern and Action Carolee Polek, RN, PhD, AOCNS; Heather Bittner Fagan, MD, MPH, FAAFP & Mary Stephens, MD, MPH, FAAFP; Martha Coppage-Lawrence, RN, MSN, CPNP & Thomas Hardie, RN, EdD, PMHCNS-BC
From the History and Archives Collection Elizabeth E. Healy, MPH
A Message from the Editor and Executive Director Omar A. Khan, MD, MHS and Timothy E. Gibbs, MPH
Welcome from this Issue’s Guest Editor Allison Karpyn, PhD
Annual Meeting Pictures Scott Ellis, photographer
Undernutrition in Refugee Children Pavitra Krishnamani, MS, BA
Obesity as a Disease Marianne Carter, MS, RD, CHES
Separating Nutrition Fact from Fiction Marianne Carter, MS, RD, CHES
Weighing In Marianne Carter, MS, RD, CHES
Social Marketing Food and Beverage Choices: It’s How You Say It Michael Peterson, EdD Obesity as a Disease page 10 www.delamed.org | www.delawarepha.org
Innovative Zoo Partnership Lending New Insight into the Power of Animals to Market Healthy Food to Kids
Nutrition for Seniors page 24
page 17
Innovative Zoo Partnership Lending New Insight into the Power of Animals to Market Healthy Food to Kids Allison Karpyn, PhD; Michael Allen; Meryl Gardner & Samantha Marks
Policies that Challenge Food Sustainability and Public Health
June 2017 Nutrition is vital to living and maintaining a healthy lifestyle. Poor nutrition can result in a variety of nutrition-related diseases. By following the general guidelines laid out in the food pyramid, people can reduce thier chances of developing health issues and enjoy a better quality of life.
Baylen J. Linnekin, JD, LLM
Preconception Nutrition Karen Antell, MD, MPH, FAAFP
Meeting the New 2015-2020 Dietary Guidelines for Americans Amy Deahl-Greenlaw, RD and Samantha Marks, RD
Nutrition for Seniors Ina Li, MD
From the History and Archives Collection Elizabeth E. Healy, MPH
Welcome from this Issue’s Guest Editor Delaware Attorney General Matt Denn
A Message from the Editor and Executive Director Omar A. Khan, MD, MHS and Timothy E. Gibbs, MPH, NPMc
Everyday Violence in America: Domestic Violence, Mass Shootings, and Gun Control Eleanor M. Kiesel, Esq, MSW, PhD Noël Duckworth
Profiles in Prevention: Safe + Respectful Lauren Camphausen and Beth Hughes
Profiles in Prevention: Real Relationships Lauren Camphausen
Boys and Men as Agents of Change Alisia D. Drew
Listening to the Wounded Sandra P. Medinilla, MD
Delaware Shelter Programs Integrate Project Connect Statewide Ruth Fleury-Steiner, Noël Duckworth & Elizabeth Miller, MD, PhD, FSAHM
Glossary of Terms Reducing Bullying in Delaware Schools Delaware Attorney General Matt Denn
The National Accreditation of the Delaware Division of Public Health Paul Silverman, DrPH and Karyl Rattay, MD, MS
Engaging Stakeholders to Develop a Patient-Centered Research Agenda for CKD in Delaware Sarahfaye Dolman, MPH, MTA
National Violent Death Reporting System (NVDRS) Mathew Christensen
Utilizing STEADI to Address Falls in Your Older Adult Patients Funding Federal Public Health Programs Katherine Smith, MD, MPH and Timothy E. Gibbs, MPH, NPMc
A Quest for Safety: Helping Delaware Students Find Peace Lanae S. Ampersand, LCSW, CPS and Joyce C. Persing, LCSW
Using Causality to Create Safe, Healthy Communities Hildy Gottlieb
Violence in Delaware: Stakeholders Directory Violence And Children David Chen, MD, MPH and Iman Sharif, MD, MPH, MS
From the History & Archives Collection
Elizabeth E. Healy, MPH
Welcome from this Issue’s Guest Editors Gerard Gallucci, MD, MHS and Aileen Fink, PhD
A Brief History of the Delaware Academy of Medicine at Christiana Hospital Joseph F. Kestner Jr, MD
Place Matters: At the Intersection of Delaware Medicine and Population Health Timothy E. Gibbs, MPH, NPMc; Omar A. Khan, MD, MHS & Daniel J. Meara, MD, DMD
An Interview with Jim Lafferty
October 2016 Violence is a public health issue affecting people of all ages, races, ethnicities, and demographics. As a result of the undeniable consequences violence has had on community and individual health, increased prevention efforts and policy changes have been implemented nationally and internationally. Through continued public health efforts and approaches, the impact of violence can be reduced, and violent behaviors prevented.
Delaware Journal of
Volume 2 | Issue 5
December 2016
Public Health A publication of the Delaware Academy of Medicine / Delaware Public Health Association
Conducted by Timothy E. Gibbs, MPH, NPMc and Gerry Gallucci, MD, MHS
1st Year Anniversary
Growing Psychiatrist Shortages and the Role of Telepsychiatry in Delaware Imran Trimzi, MD; Carolyn Morris, MHSA; Asma Mian, MD & Gerard Gallucci, MD, MHS
The A’s of Influencing Healthy Eating and Active Living Michelle Eichinger, MS, MPA
When Planning Meets Health: Delaware’s Plan4Health Grant Fosters a Healthy Delaware Michelle Eichinger, MS, MPA and Kristen Vales & the Delaware Plan4Health team
Quantifying Medical Interpreter Activity: A Time-Motion Study
Frank C Mayer III, MBA; Danielle L. Mosby, MPH; Alexandra Nightingale, BS; Elizabeth J. Brown, MD, MSHP; Sarahfaye Heckler, MPH, MTA; Richard Caplan, PhD; Jacqueline Ortiz, MPhil; Claudia Angelica Reyes- Hull, MA; Adebayo Gbadebo, MBA & Tze Chiam, PhD
Alzheimer’s Disease: Our Evolving View, Our New Interventions James M. Ellison, MD, MPH and Katie Macklin, MPA, BS
Why Trauma Matters in Delaware Leslie Brower, PhD, RN
A Guide to Involuntary Commitment in Delaware
Michelle Joy, MD; Sundeep Virdi, JD, MD; Mustafa Mufti, MD & Clarence Watson, JD, MD
Psychiatric Service Utilization Trends in Delaware’s Public Mental Health System Aileen Rothbard, PhD; Cynthia Zubritsky; Sumedha Chattre, PhD; Bridget Keogh, MPH; Hilary Cantiello, MLA & Susan Holloway, MPA
Cigarettes & Psychotropic Medications: A Sstudy of the Prescription Pattern in an Inpatient Setting Sehba-Husain-Krautter, MD, PhD; Connie Chang, MD; Thomas A. O’Hara, MS; Joseph Esposito, MD; Vallabh Suryadevara, MD; Dolly Mishra, DO; Kiran Luther, MD & Gerard Gallucci, MD, MHS
Voices of the Delaware Community Reintegration Support Program (CRISP)
Cynthia Zubritsky, PhD; Sumedha Chhattre, PhD; Bridget Keogh, MPH; Hilary Cantiello, MLA; Michael Barbieri & Aileen Rothbard, ScD
Understanding and Approaching the Increase in Suicide Rate with a Special Focus on Delaware Cynthia Zubritsky, PhD; Sumedha Chhattre, PhD; Bridget Keogh, MPH; Hilary Cantiello, MLA; Michael Barbieri & Aileen Rothbard, ScD
The Impact of ACEs on Health-related Quality of Life, Mental Health, and Hospitalizations in Delaware Khaleel S. Hussaini, PhD; Tabatha-Offutt Powell, DrPH; Mathew Christensen, PhD & Leah Woodall, MPA
The Relative Contributions of ACES’ and Healthy Environments to Child Flourishing in Delaware Dana Thompson, MPH; Iman Sharif, MD, MPH & Aileen Fink, PhD
Improving Behavioral Health Care for Delaware’s Children in Foster Care: A Public Health Imperative Aileen D. Fink, PhD; Thomas I. Mackie, PhD, MPH & Christopher Bellonci, MD, DFAACAP
ACEs Negatively Impact Health Behaviors and Chronic Disease Risk Among Adults Residing in Delaware Caprice A. Torrance, MHA; Kimberly Williams, MPH; Elizabeth Brown, MD; Kirsten Olson; Andrea Miller; Leslie Newman & Mia A Papas, PhD
Delaware CORE : Early Psychosis Prevention in the First State
Charles Webb, PhD; Samantha Eklund, MC; Adina Seidenfeld, PhD; Geeta Kotak, MSW & Timothy Fowles, PhD
From the History & Archives Collection Elizabeth E. Healy, MPH
BEHAVIORAL HEALtH ...an integral piece of the public health puzzle
www.delamed.org | www.delawarepha.org
December 2016 Behavioral health is an all-encompassing term focused on mental health disorders as well as substance abuse and addiction. Behavioral Health focuses on individual health decisions, and how culture, socioeconomics, environment, physical health, emotional health, genetics, and more, translate into these decisions. Behavioral Health is a term often less stigmatized than mental health, and is critical to the overall health and well-being of individuals.
P R O V I D I N G A V O I C E A N D P L AT F O R M
Paradigm Shift 2.0
P U B L I C E D U C AT I O N & H E A LT H L I T E R A C Y
Delaware Mini-Medical School In its tenth year, Delaware Mini-Medical School continues our mission of educating the public by sharing the expertise of local professionals in medicine and health. Designed for individuals who want to gain a deeper understanding of the world of medicine, Mini-Medical School is a free, six-week series of lectures for adults of all ages and high school students co-sponsored with the Christiana Care Health System. Attendees learn about important trends in diagnosing and treating illness and general health topics. Faculty provide in-depth lectures and allow time for questions to enhance the experience. There are no tests or grades. No previous medical training is required. Participants who attend all six sessions receive a Certificate of Achievement There is no cost to attend this event which is co-sponsored by Christiana Care Health System and the Delaware Academy of Medicine / Delaware Public Health Association From middle and high school students to retired adult learners (and everyone in between) we take our cues on topics from audience feedback and add topics of emergent and/or continuing importance in our community as identified by the planning and curriculum committee for Delaware Mini-Medical School. Each lecture attracted between 100 and 150 participants, some seeking guidance in career choices, others looking to make positive changes to improve their own health, and still others just wanting to learn more about advances in modern medicine. In addition to improving the public’s understanding of medicine, the series is aimed at encouraging middle and high school students to learn about medicine and health as possible career options. We also seek to address health literacy: the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
The 2016 series covered the following topics: • Heart Failure: What is It? Who has It? and How to Treat It. Mitchell T. Saltzberg, MD • Gene Editing: Is the Age of Genetic Surgery Upon Us? Eric Kmiec, PhD • Drugs, Alcohol, and Addiction – Re-Considering Addiction: Lessons from Other Chronic Illnesses. Mark Lanyon, PhD • The Impact of Stress and How to Cope. Margaret Keenan, PhD • Concussions – Getting Your Head Out of the Game. Kristopher Fayock, MD and Tom Buckley, PhD •Geriatrics – A Specialty for Complex Primary Care. Ina I. Li, MD
Each year, with the support of a fund established by the Hoopes Family held at the Delaware Community Foundation, and in partnership with the Delaware State Dental Society, we are pleased to present the Frank M. and Robert R. Hoopes Medical/Dental Lecture. Frank Hoopes was ahead of his time in recognizing this need for medical-dental collaboration, a subject in which he was especially interested. In 2016, CAPT Matthew Jacks, DC USN, Department Chief, Oral and Maxillofacial Surgery at Walter Reed Medical Center presented “Bisphosphonate related osteonecrosis of the jaw (BRONJ): Diagnosis, Management, and Treatment.�
FOCUS ON HYPERTENSION High blood pressure or hypertension (HTN) increases the risk of heart diease and stroke. Risk factors include consuming too much alcohol, obesity, family history, and smoking. According to the American Heart Association, one out of every three adults over the age of 20 is affected by hypertension. The annual conference covered the following topics in 2016: adolescent HTN, excess sodium reabsorption in kidney disease and HTN, medication adherence, secondary HTN: adrenal disorder, solid organ transplant hypertension, resistant HTN, and CKD and HTN influence on progression to End State Renal Disease.
DELAWARE PrEP SUMMIT In partnership with the Delaware HIV Consortium and the Medical Society of Delaware, we were pleased to host the Delaware PrEP Summit promoting the awareness and use of the once-a-day pill that may help us eliminate HIV/AIDS. This educational activity brought national experts in the field to Delaware to talk about the clinical aspects of PrEP, using PrEP in the community practice setting, placing PrEP within the larger HIV/AIDS strategy, and audience familiarization with AETC (The PrEP Toolkit for High Risk Individuals).
STROKE EDUCATION CONFERENCE Now in its 15th year, this annual conference honors the life and dedication of John Scholz, PT, PhD. Dr Scholz was a highly regarded movement scientist renowned for his ability to take complex theoretical concepts of motor control and apply them to the understanding and treatment of neurologic problems. Dr Scholz was professor of Physical Therapy at the University of Delaware, and, for many years, a member of the Board of Directors of the Delaware Stroke Initiative (DSI). This conference is jointly presented by the DSI and Academy/DPHA. The 2016 conference covered stroke genetics, lipds and stroke, triaging out of hospital stroke patients, driving after a stroke, sleep apnea and stroke, depression and fatigue after stroke, aphasia, treatment of carotid stenosis, diabetes and stroke, advances in robot assisted rehabilitation, medication compliance, afib and stroke, an interdisciplinary approach to stroke rehabilitation, and stroke in women.
MILITARY AND VETERANS MENTAL HEALTH SUMMIT In partnership with the Mental Health Association of Delaware and the Delaware Military & Veterans Suicide Prevention Coalition, we were honored to partner for the 2016 conference. Our participation in this conference is an outgrowth of our previous Military Medicine Symposia, directly addressing some of the most pressing needs of our deployed armed forces and our veterans. Topics included mental health and the military, addictions and suicide, veteran access, and a review of the Delaware Air National Guard Suicide Prevention Program.
P R O F E S S I O N A L D E N TA L A N D M E D I C A L E D U C AT I O N
HOOPES MEDICAL/DENTAL LECTURESHIP
P U B L I C H E A LT H P R O G R A M S & E N G A G E M E N T
The ICD is a program of the Academy/DPHA operated jointly with the Delaware Division of Public Health and partially funded by a grant from the Centers for Disease Control and Prevention. The mission of the ICD is to bring together local, state, and community organizations and individuals to promote education about vaccine preventable diseases and new vaccines, with the goal of ensuring that no one in Delaware suffers from vaccine preventable illness. In 2016, ICD co-chairs Stephen Eppes, MD and Michelle Power, MT (ASCP), CIC, Infection Control Practitioner, worked with ICD program manager Kate Smith, MD, MPH to educate about, advocate for, and improve access to vaccines and immunization throughout Delaware. Additionally, Ms. Power was presented with the 2016 CDC Childhood Immunization Champion Award. She has two decades of experience as a medical technologist in microbiology and immunobiology laboratories, and brings that knowledge to the Christiana Care Health System. Ms. Power has advocated for universal immunization of children and the elimination of non-medical exemptions, and is currently leading efforts to reduce the impact of non-medical exemptions in Delaware. With support from Delaware Hospitals and Health Centers, the Delaware Division of Public Health, Universities and School Nurses, Pharmaceutical Companies, and other Professional Associations, the ICD strives to reduce disparities in access to immunizations for all ages; advocate for policy issues related to childhood, adolescent, and adult immunizations; and strengthen the healthcare process and outcomes of vaccine preventable diseases for all of Delaware’s residents.
In 2016, the Academy/DPHA was tasked by the Delaware Department of Health and Social Services with overseeing the implementation, training, and research associated with the DMOST program. This program is designed to improve the quality of care people receive at the end of life by translating patient goals and preferences into medical orders. The program is based on the national Physician Orders for Life Sustaining Treatment (POLST) paradigm, which was initially implemented in Oregon in 1991. The DMOST form is a single document that functions as an actionable medical order; transitions through all healthcare settings with a patient; and is based on communication between the patient, their designated decisionmaker, and healthcare professionals. Training and use of the form began in April, 2016, and is headed by the DMOST program manager, Kate Smith, MD, MPH. The program educates healthcare professionals, informs Delaware residents, and seeks to increase Advance Care Planning and the use of end-of-life documents in the state of Delaware. As a result of this program, the Academy/DPHA adopted its first full-featured online training portal, powered by a Learning Management System named Litmos. In its first year of operation, over 350 Delaware healthcare providers have used the online system to learn about DMOST. Another 150 have had live training provided directly by Dr. Smith. Our peer-to-peer training program starts in January of 2017. Parallel training has been conducted in the EMS and Skilled Nursing Facility sectors by our partners. This program is supported by funding from the Christiana Care Health System’s Harrington Value Institute Community Partnership Fund and by the Highmark Foundation.
The Academy/DPHA is honored to work in partnership with our colleagues at the Value Institute at Christiana Care Health System on Delaware’s first Patient-Centered Outcomes Research Institute (PCORI) Engagement Award. More than 20 million people over the age of 20 in the United States have Chronic Kidney Disease (CKD). Because CKD patients have multiple comorbid conditions, they see numerous healthcare providers. Poor communication between physicians, as well as different electronic health records systems throughout the state of Delaware, create fragmented patient care, resulting in suboptimal clinical outcomes. A CKD registry in development in Delaware seeks to join the electronic health records of multiple sources to improve coordination of care. A team of patients, clinicians, and researchers will collaborate to gather information and facilitate Patient-Centered Outcomes Research (PCOR) based on the CKD registry. The aims of this project are to understand which outcomes and research questions patients, physicians, and payers are most interested in; what additional data would be important for PCOR; and to solicit feedback on research designs, privacy issues, and data sharing in the context of PCOR. These objectives will be addressed through two conferences and a community academic workgroup. The role of the Academy/DPHA is to provide dissementation expertise, as well as conference planning and support for this unique initiative.
The Delaware Chapter of the American Planning Association and the Delaware Academy of Medicine/Delaware Public Health Association have received a $135,000 grant from the American Planning Association through its Plan4Health program to combat two determinants of chronic disease: lack of physical activity and lack of access to nutritious foods. Funding for Plan4Health was provided through an award from the Centers for Disease Control and Prevention (CDC) to the American Planning Association and the American Public Health Association (APHA) at the state level. This represents a new major collaboration between planners and public health professionals. The Delaware Plan4Health initiative seeks to change the approach in which comprehensive plans are updated to include considerations for public health and equity. Using feedback from the community, the Coalition will create land use, design, and policy guidelines for planners and public health professionals seeking to increase access to healthy food and build spaces that encourage physical activity. Focusing on the City of Dover and on Kent County in two parallel paths, Plan4Health isusing the Socio-Ecological model to implement a systems change approach in how comprehensive plans are updated. We are creating a model to ensure public health and equity are integrated in planning for communities statewide. Our model will address opportunities for: • Physical activity, by increasing access to parks and recreation facilities and improving sidewalk and bicycle path connectivity and infrastructure; • Healthy eating, by increasing accessibility, affordability, and availability of healthy foods; and • Improved land use patterns and urban design to facilitate these measures.
P U B L I C H E A LT H P R O G R A M S & E N G A G E M E N T
Partners in Research: Delaware CKD Engagement Project
C U LT I VAT I N G T O M O R R O W ’ S P R O F E S S I O N A L S
Student Financial Aid The Academy’s Student Financial Aid program was established in 1961 to help encourage Delaware students to study medicine and dentistry. To date, over 300 students have received close to $2 million in loans. While the Academy has funds to support both medical and dental students, for the past several years we have only received applications from medical students. The program is self-sustaining in that the loans are given based on the amount of money collected annually from the students after they graduate. The maximum loan amount was increased to $10,000 in 2016 to help with the rising costs of tuition. According to the American Medical Association, most medical/dental students come out of school with an average of $170,000 in student loans. To relieve some of the debt burden, repayment doesn’t begin until one year after the students graduate, and interest rates are kept lower than most government and private loans. Students also get to select between a 10 and 15 year repayment period. In 2016, the Delaware Academy of Medicine approved $60,000 in loans for 6 Delaware students studying medicine. Of the 6 students, 4 are enrolled at Sidney Kimmel Medical College, 1 at the Philadelphia College of Osteopathic Medicine, and 1 at Washington University School of Medicine. Our 2016 graduates enrolled in residencies at Hahnemann University Hospital in Philadelphia, PA, Scripps Green Hospital in San Diego, CA, and Abington Memorial Hospital in Abington, PA. Any student interested in applying for a loan can submit an application to the Academy by May 15th of each year. To be eligible, students must be Delaware residents enrolled in medicine or dentistry at an accredited graduate school. Funds are made available through endowments established by doctors, dentists, and other benefactors. The Delaware Academy of Medicine has six separate funds specifically for the purpose of issuing student loans. Operations manager, Liz Lenz, oversees the SFA loan program as well as the rest of the Academy/DPHA finances. MEDICINE “I grateful that with the help of the Delaware Academy of Medicine loan, I was able to go into the clinical years of medical school with a truly open mind, without any financial pressures influencing my choice of specialty. I am very excited to be starting a residency in Internal Medicine this summer!” Charlotte Lin, M.D.
In 2012, the Delaware Academy of Medicine initiated a pilot program to provide a highly customized internship program for a variety of age and educational stage learners. During 2016 we accepted three interns to explore and learn with us. PUBLIC HEALTH Madeline Brooks, a native of Newark, DE, is pursuing a Master of Public Health (MPH) degree at Thomas Jefferson University. She obtained her bachelor’s degree from the University of Delaware and spent three years as an intern/ communications specialist at the AstraZeneca HealthCare Foundation. Madeline created a listing of health-related data collection projects taking place in Delaware, as well as a glossary and resource directory on the topic of violence and public health. She recently wrote an article on the role of social support in preventing and managing diabetes, which was published in the March 2017 issue of the Delaware Journal of Public Health.
HISTORY Kathryn Lenart is pursuing a Master’s Degree in History and a Certificate in Museum Studies at the University of Delaware. Kate previously completed her Bachelor’s Degree in History at Villanova University, where she also studied economics and business. In addition to her studies and related public history projects, she is a founding member of Delaware’s Museum Property Law Project, which advocates for legislation regarding abandoned cultural property. Kate’s research interests include 20th century popular culture in the United States and the points of intersection between popular culture, politics, and economics. Kate has accepted an archival position at LancasterHistory.org after graduation.
LAW Anne Grae Martin is a senior at the University of Delaware majoring English with a concentration in Professional Writing, with minors in French and Spanish. In her free time, Anne Grae serves as the president of the Mock Trial Club and the French Club, is a Student Alumni Ambassador, and is the editor of the University of Delaware Honors Program blog. After graduation, Anne Grae plans to attend the George Washington School of Law in Washington, DC.
C U LT I VAT I N G T O M O R R O W ’ S P R O F E S S I O N A L S
Internship Program
PA R T N E R I N G I N R E S I D E N T E D U C AT I O N
Global Health The Christiana Care Health System’s Global Health Curriculum, with the support of the Delaware Academy of Medicine, the Delaware Public Health Association, and the Delaware Academy of Family Physicians, is an interdepartmental collaboration between the Departments of Medicine and Family Medicine, and the Med-Peds Residency Program, to encourage education and interest in the Global Health Field.
The Global Health Series is open to the public, and in 2016 covered a range of timely topics including: • Healthcare Crisis for Syrian Refugees A group discussion • Making a Diagnosis in an Under Resourced Setting: The Physical Exam Presented by Matthew J. Burday, DO • Pediatric Refugee Care Presented by Christopher Raab, MD • Training and Career Opportunities in Tropical Medicine & Global Health Presented by Ann Fazakerley and Marci Drees, MD, MS • Zika Presented by Steve Eppes, MD and Irini Daskalaki, MD • What is Global Health and Why Should I Care? Presented by Omar Khan, MD, MHS; Karla Testa, MD; and Ellen Plumb, MD • Global Health at Home: South Asians and Coronary Disease Presented by Vinay Hosmane, MD, MPH • Sustainable Solutions to Maternal Child Health Disparities Presented by Michelle L. Drew, DNP, MPH
In 2016 we were afforded a wonderful opportunity to highlight some of the major accomplishments of the Academy/DPHA, as well as exhibit many of the medical, dental and nursing memorabilia housed in both our collection and those of the Medical Society of Delaware, the University of Delaware, the Delaware Historical Society, and several other state museums and historical societies. This was made possible by the use of exhibit space developed by the Delaware Historical Society at its newly renovated location at Sixth and Market Streets in downtown Wilmington. As part of its mission, the Academy/DPHA believes it is important to preserve and protect the history of the health professions in Delaware. Since its founding in 1930, the Academy has acquired important and mundane equipment, pharmaceuticals, instruments and documents from members and others interested in preserving this history. For this exhibit, a span of 150 years was selected (1817-1967) to show the major changes in the practice of medicine. Among the items on display are: •
The Margaret Handy-Katherine Esterly collection of infant feeders: glass, porcelain, and other types of bottles and pitchers used to feed infants prior to the development of the modern bottle;
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A collection of Civil War surgical instruments, primarily used for trauma surgery on wounded soldiers;
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Typical traveling instruments of dentists, opticians, and physicians in the days of house calls;
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Nineteenth and early twentieth century microscopes;
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Examples of useful, and sometimes useless or harmful, drugs dispensed by pharmacists, allopathic, and homeopathic physicians;
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Nursing uniforms, caps and pins that remind us of the origins of nursing education in hospitals across the state;
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A look back at the 1962 DAM Health Fair, a massive undertaking put on in the now razed National Guard Auditorium, with over 80 exhibits including the invisible woman and a replica of the Mercury space capsule;
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Materials relating to the founding of the Medical Society of Delaware (courtesy of the MSD);
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A visual history, though pictures and picture postcards, of the development of hospital buildings in Delaware;
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A summary of major public health initiatives and programs within Delaware, and the United States.
With some exceptions, the items shown are from a time prior to 1967. It is interesting to contemplate the changes that have occurred in the last 50 years, and then to ponder how these professions will be practiced in 2067, when the items considered state-of-the-art today will appear to be similarly historically fascinating. This exhibit was prepared and curated by board member Brian Little, MD, PhD, and Academy/DPHA intern Kathryn Lenart. It will be open to the public at the Delaware Historical Society’s 5th and Market Street location in Wilmington, DE until the Fall of 2017.
A R C H I V E S & H I S T O R Y - P R E S E R V I N G O U R PA S T
Archives and History
ACADEMY LEADERSHIP
ACADEMY BOARD OF DIRECTORS Officers Daniel J. Meara, MD, DMD President Omar A. Khan, MD, MHS President-Elect Victor L. Gregory, DMD Vice President
EMERITUS MEMBERS OF THE BOARD Robert B. Flinn, MD Barry S. Kayne, DDS Leslie W. Whitney, MD
S. John Swanson, MD Treasurer Arun V. Malhotra, MD Immediate Past President Timothy E. Gibbs, MPH, NPMc Executive Director, Ex-officio and Acting Secretary Directors David M. Bercaw, MD At-Large Member Cynthia A. Gabrielli, DO Chair, Student Financial Aid Committee Eric T. Johnson, MD At-Large Member Joseph F. Kestner, Jr, MD Bylaws Committee Brian W. Little, MD, PhD Chair, History and Archives Committee Kathleen W. McNicholas, MD, JD Personnel Committee Joseph A. Napoli, MD, DDS At-Large Member John P. Piper, MD At-Large Member Anita P. Raghuwanski, M.D. At-Large Member Albert A. Rizzo, MD Chair, Program Committee
Top Row, left to right: Dr. Gregory, Dr. Swanson, Dr. Khan, Mr. Gibbs Dr. Kestner, Dr. Little, Dr. Bercaw Bottom Row, left to right: Dr. McNicholas, Dr. Meara, Dr. Malhotra, Dr. Raghuwanshi, Dr. Johnson, Dr. Kayne Absent from picture: Dr. Gabrielli, Dr. Napoli, Dr. Rizzo, Dr. Flinn, and Dr. Whitney.
INVESTMENT ADVISORY COUNCIL 2016 J. Kent Riegel, Esq. Chair Martin G. Mand, MBA Richard L. Laird, Jr., MC, BA H. Rodney Scott
Omar A. Khan, MD, MHS President Timothy E. Gibbs, MPH, NPMc Executive Director, Ex-officio Louis E. Bartoshesky, MD, MPH Gerard Gallucci, MD, MSH Richard E. Killingsworth, MPH Erin K. Knight, PhD Melissa K. Melby, PhD Mia A. Papas, PhD Karyl T. Rattay, MD, MS Margot L. Savoy, MD, MPH Rob A. Simmons, DrPH William J. Swiatek, MA, AICP
ADVISORY COUNCILS
DPHA ADVISORY COUNCIL
D E L AWA R E ACADEMY of MEDICINE
Suite L10 4765 Ogletown Stanton Road Newark, DE 19713 302-733-3900 www.delamed.org www.delawarepha.org