Medicine and Health Sciences Commons^™

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

The Application Of The Literature Review Appraisal Toolkit On Environmental Health Systematic Reviews, Kristen M. Davis

Master's Projects and Capstones

Environmental health systematic reviews have long been of poor quality when comparing them to clinical health systematic reviews. The main reason for the poor quality of environmental health systematic reviews is the lack of a specific protocol. The University of California-San Francisco’s Program for Reproductive Health and the Environment has, because of the discrepancy, created a protocol specific to conducting environmental health systematic reviews. The protocols efforts would be futile without a nonbiased way to evaluate systematic reviews and therefore the protocol used. The Literature Review Appraisal Toolkit is a valuable tool created to navigate and evaluate the credibility of …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …

Geographical Incidence Of Antimicrobial Resistant Gonorrhea, Christofer A. Rodriguez

Master's Projects and Capstones

Evolving throughout the last century, Gonorrhea has become a superbug, becoming difficult to treat. As the second most commonly reported notifiable disease, gonorrhea rates have been increasing, despite efforts in prevention and treatment. Populations at risk are mainly MSM and FSW. In 2015, men’s gonorrhea rates in the United States were higher compared to women, at 140.9 and 107.2 per 100,000 population, respectively. Illinois has consecutively had higher rates of infection compared to the US, at 133.5 per 100,000 population compared to the US rate of 123.9 per 100,000 population. The surveillance of gonococcal isolate resistance to current antimicrobials began …

Doula Support As A Means To Improve Birth Outcomes For Minority Women, Christina Bao Ngoc Thich

Master's Projects and Capstones

Ethnic minorities such as African Americans, American Indians, Hispanics, Laotions, Hmongs, and Alaskan Natives have higher rates of cesarean delivery, pre-term birth, fetal demise, perinatal laceration, and congenital abnormalities than their white counterparts. Continuous labor support by way of doula care has been recommended for all pregnant women as a means to prevent adverse birth outcomes. Despite this, the population most in need of such support in unable to access doula services due to low socioeconomic status, availability of services, and cultural inaccessibility. This paper focuses on my capstone experience with UCSF and Roots of Labor Birth Collective as we …

Pharmacovigilance In Post-Marketing: Risk Assessment And Reporting Standards, Tiffany Jee

Master's Projects and Capstones

While there has been new targeted drug therapies released into the market over the recent years, pulmonary arterial hypertension (PAH) remains to be a rapidly progressive disease with poor prognosis. Over time the arteries stiffen and tighten subsequently leaving the heart to pump harder to try and provide enough blood to the body. The extra stress of the increased pumping leads to weakening and enlargement of the heart. The endothelin targeted therapy, Letairis (ambrisentan), is an oral tablet proven to improve quality of life in patients suffering from PAH, WHO Group I – functional class II and III by helping …

Using Multi-Modal Education In A Public Health System To Increase Rates Of Cervical Cancer Screening, Christina Nardi

Doctor of Nursing Practice (DNP) Projects

While Papanicolaou (Pap) screening has been implemented since the 1950’s, and is linked to decreased rates of cervical cancer, national screening rates are still below the national target screening rate. In Contra Costa County (CCC), the current cervical cancer screening rate is 50.92% (Contra Costa Health Services [CCHS], 2016a). This is far below the national goal of 93% and the first benchmark of 54.33% needed in order to receive state funding under the California Department of Health Care Services (DHCS) Medi-Cal 2020 waiver. The Medi-Cal 2020 waiver has a 5-year Public Health Incentives and Redesign in Medi-Cal (PRIME) program requiring …

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …

Mental Health Workout: Lifting Stigma, Jeremy Bambery

Master's Projects and Capstones

Mental illness affects one out of every five Americans between the ages 13-18, and it is estimated that two-thirds of these individuals will not seek treatment due to the stigma associated with having a mental illness or mental health issue (National Alliance on Mental Illness). Access to information and the ability to talk openly without fear will aid in creating a stigma free future. The goal of this project is to supply high school students in the San Francisco Bay Area with information regarding the stigma associated with mental health and mental illness via videos that will be used as …

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects and Capstones

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used to determine the adjusted association of 25(OH)D categories with …

Kinder Ready: Exploring The Role Of Technology In Promoting School Readiness Among Low-Income Parents In A Clinic-Based Setting, Brenda Lu

Master's Projects and Capstones

The Stanford Pediatric Advocacy Program advocates to improve the health status of children in Silicon Valley and the surrounding community. This summer, I worked on a project called Kinder Ready, with the goal of evaluating the feasibility of technology use in promoting school readiness in children ages zero to five. We used a variety of qualitative research methods, including focus groups, one-on-one interviews, and surveys to collect feedback from the community on what their children need to transition into schools. Our local participatory research approach has paved the way for many new partnerships with local organizations, while strengthening existing ones. …

Quality Management: A Global Case Study In Organ Transplantation, Cassie L. Rodriguez

Master's Projects and Capstones

Every year the US and European countries face an epidemic of organ failure from a multitude of reasons: cancer, genetic predisposition, exposure to harmful chemicals in home or surrounding areas or through drinking, drugs and smoking. Another problem faced, is the ratio of organ donors to organ recipients. Over 121,000 patients are on the waiting for an organ transplant, and a fraction of those waiting will die because of time. The Hanover Medical school and department of quality management, have created an integrated approach to organ transplant avenues. Quality management is a systematic guide for organ transplantation that allows all …

Exploring The Role Of Pharmacists In Management Of Hypertension In A Safety Net Clinic, Pandora Lau

Master's Projects and Capstones

Potrero Hill Health Center through the San Francisco Department of Public Health aims to deliver health promotion, disease prevention, heath maintenance, counseling, and health education of acute and chronic diseases. Hypertension is a common problem to both the health center and to the general population, and Potrero Hill Health Center aims to understand and develop a program that will aid in hypertension management at their local clinic. A supplemental pharmacist service was implemented at Potrero Hill Health Center to help manage hypertensive patients. Systolic and diastolic blood pressure levels were compared in patients receiving pharmacist counseling versus those receiving physician …

Improving Data Collection To Reduce Maternal And Infant Mortality And Morbidity In Malawi: Evaluating Chimwemwe Mu'bereki, A Community Based Intervention, Alexandra E. H. Jones

Master's Projects and Capstones

Maternal and infant death rates in Malawi are among the highest in the world. Over 17 million people live in this small country in sub-Saharan Africa, where the country’s life expectancy is just 60.6 years (World Bank, 2015). These deaths can be attributed to many complex factors, including cultural practices, lack of adequate medical equipment, long travel distances to health facilities, low staffing at hospitals and clinics, extreme poverty, and malnutrition. Without government support and intervention, community groups must fill in the gaps to make needed improvements to maternal and infant health outcomes. African Mothers Health Initiative (AMHI) enrolls high …

Improving Workplace Wellness At Kaiser Permanente, Megan Conolly

Master's Projects and Capstones

A sedentary lifestyle is linked to many serious health problems including cardiovascular disease, obesity, and early death. Since the majority of jobs are done at a desk, those in the workforce have become particularly vulnerable to becoming sedentary. Workplace wellness programs are beginning to become a more common practice, and Kaiser Permanente is leading the way. However, they are discovering that simply providing resources is not enough. To enhance their workplace wellness, the Wellness Leaders program was implemented in order to get all departments involved in wellness activities and practices. While the program continues to grow, a shift in the …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Partnerships For Change: A Collaboration For Global Wellbeing, Ravneet Gill

Master's Projects and Capstones

Partnerships For change (PFC) consists of a team of social impact strategists and practitioners. The organization is dedicated to promote sustainable development through direct humanitarian action and transforming social and economic conditions of underserved communities around the globe. With the commitment to elevate and empower individuals to reach their ultimate potential, PFC partnered with Jaipur foot, world's largest organization for prosthetic devices, to network Jaipur Foot to innovators and funders. They have also started the building of a health clinic in Johnsonville, Liberia due to inadequate medical support for individuals living in the community. There are several steps in building …

Unicef Kid Power: Empowering Kids To Get Active And Save Lives, Emily L. Gudaitis

Master's Projects and Capstones

UNICEF Kid Power is a program aimed at increasing U.S. children’s activity levels by tapping into children’s intrinsic desire to do good. Through their activity levels, kids earn points, which unlocks funding from partners that will support treatment for a malnourished child. This one-of-a-kind program was implemented in the Bay Area in Spring 2016 with 7,800 youth participants. The attached paper is a summary of a 300-hour fieldwork experience at the U.S. Fund for UNICEF assisting with the UNICEF Kid Power implementation in the Bay Area. The fieldwork included program implementation and evaluation, presentations at participating schools in the area, …

Healthy Stores For Healthy Communities, Camila Suarez

Master's Projects and Capstones

Overall smoking rates in California, and nationwide, have steadily declined since the first surgeon’s general report, in the 1960s, stated that tobacco may lead to cancer. In the past five years, the emergence of Electronic smoking devices or Electronic Nicotine Delivery System (ENDS), little cigarillos, vapes, and hookah have increased smoking rates among teenagers and young adults throughout California. The rise of smokeless tobacco products can be attributed to a variety of reasons from marketing, product availability, flavor availability, and public misconceptions. In 2016, the Santa Clara County Department of Public Health launched the Healthy Stores for a Healthy Community …

Establishing A Patient Safety Pilot Program In Ucsf Medical Center – Benioff Children’S Hospital: Principles, System Analysis, And Initial Steps, Paige Porter

Master's Projects and Capstones

Patient safety is a serious public health issue impacting individuals in all healthcare settings. UCSF Medical Center is a leading healthcare organization in San Francisco, dedicated to providing the safest and highest quality care to its patients. In an effort to further promote patient safety, the Family Escalation Project was created to enhance the communication between patients, families, and healthcare providers in the UCSF Benioff Children’s Hospital. This project was created in response to an adverse event in which a safety concern was not appropriately escalated. The goal of the project is to create a mechanism for patients and families …

The Complexity Of Non-Profit Administration In Global Development: A Case-Study On Neonatal Mortality, Paul D. Glantz

Master's Projects and Capstones

In 2015, 5.9 million children died with 44% of those deaths occurring in the most vulnerable period of life: the neonatal period (first 28 days of life). Because this is such a pervasive problem, in order to meet the United Nation’s third Sustainable Development Goal of reducing the global neonatal mortality rate down from 27 to 12 deaths per 1,000 live births, there needs to be more evidence-based, effective interventions. Thrive Networks addresses newborn mortality by improving facility-based care in low-resource settings via intensive training and lifesaving medical equipment built to operate in these conditions. Despite all of the evidence …

Breast Cancer Fund: Power Mapping For Policy Change, Roxanna Firouzian

Master's Projects and Capstones

The following paper is a summary on a 300-hour fieldwork experience at the Breast Cancer Fund. The Breast Cancer Fund (BCF) is a non-profit organization based in San Francisco, CA that partners with organizations across the nation to expand their reach and health education. BCF works to expose and eliminate toxic chemicals in the environment that are linked to breast cancer, immunotoxicity, and reproductive and developmental issues. BCF accomplishes these goals through public awareness and pushing for policy change. In April 2015, Senators Diane Feinstein and Susan Collins introduced the Personal Care Products Safety Act. This is the first bill …

Effective Health Communication Measures Within The Silicon Valley, Lauren V. Rodrigues

Master's Projects and Capstones

Effective and reliable communication is vital in the field of Public Health. Fieldwork conducted with the Silicon Valley Leadership Group’s Communication Team demonstrated the importance of using various social media platforms to effectively reach the largest audience. Content creators need to be aware of the target audience and identify the appropriate communication platform in order to provide relevant information in the most user-friendly and efficient manner. This paper is a summary of a 300 hour fieldwork experience completed through an internship with the Silicon Valley Leadership Group.

Decolonize Your Diet, Jasmine A. Deras

Master's Projects and Capstones

With the industrialization of the food system in past decades, convenience foods have become the cornerstone of the standard American diet. This spike in obesity rates has been more impactful for some populations than for others. In low-income communities of color, fast and processed foods are often the most accessible and affordable source of sustenance. Critical indicators of status and well-being, health disparities are one example of the social barriers faced by predominately low-income people of color.

The Decolonize Your Diet project channels principles of resistance into its mission to improve the health of people of color in Oakland, California. …

Implementing Change To Decrease The Emergency Department Visits For Pediatric Clients Referred To Mental Health Services, Diane Sandoval

Master's Projects and Capstones

The purpose of this clinical nurse leader (CNL) internship project is to implement an improvement intervention to decrease emergency department visits or psychiatric emergency services visit rates for pediatric clients receiving mental health services through the ambulatory clinic. The goal is to increase client safety by preventing harm to themselves or others and improving quality of care provided through timely nursing telephone triage. The project is taking place in a county run pediatric ambulatory clinic. We will participate in a shared leadership team to make recommendations for improvement at the microsystem level. Team members include the charge nurse, clinic manager, …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Redefining Medicine: The Epistemology, Political Theory, And Phenomenology Of Health And Disease, Jacqline J. Murillo

Creative Activity and Research Day - CARD

This thesis argues that health needs to be redefined in a more comprehensive fashion, namely as a physiological/biological state, with social, environmental, and individual determinants always related to one’s personal needs to achieve one’s life plan. The benefits of this new definition include more emphasis on the distribution of health as a social good.

Additionally, redefining health puts the value of the individual’s life rather than the strict monetary value of their needed treatment as a focal point. It also draws more attention to medicine as a practice of care, rather than viewing it simply as a technology or science, …

Violent Death Rates: The United States Compared To Other High-Income Oecd Countries, 2010, Erin Grinshteyn, David Hemenway

Nursing and Health Professions Faculty Research and Publications

Background: Violent death is a serious problem in the US. Previous research showing US rates of violent death compared with other high-income countries used data that are more than a decade old.

Methods: We examined 2010 mortality data obtained from the WHO for populous, high-income countries (n=23). Death rates per 100,000 population were calculated for each country and for the aggregation of all non-US countries overall and by age and sex. Tests of significance were performed using Poisson and negative binomial regressions. Results: US homicide rates were 7.0 times higher than other high-income countries, driven by a gun homicide rate …

The Reply, Erin Grinshteyn, David Hemenway

Nursing and Health Professions Faculty Research and Publications

The Reply. A letter to the editor in The American Journal of Medicine, Volume 129, Issue 8, 2016, Page e143 regarding Unintentional firearm deaths among children in the United States.

A Global Meta-Analysis Of Forest Bioenergy Greenhouse Gas Emission Accounting Studies, T Buchholz, M D. Hurteau, J Gunn, David Saah

Environmental Science

The potential greenhouse gas benefits of displacing fossil energy with biofuels are driving policy development in the absence of complete information. The potential carbon neutrality of forest biomass is a source of considerable scientific debate because of the complexity of dynamic forest ecosystems, varied feedstock types, and multiple energy production pathways. The lack of scientific consensus leaves decision makers struggling with contradicting technical advice. Analyzing previously published studies, our goal was to identify and prioritize those attributes of bioenergy greenhouse gas (GHG) emissions analysis that are most influential on length of carbon payback period. We investigated outcomes of 59 previously …