Digital Commons Network^™

Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht

Doctor of Nursing Practice Final Manuscripts

Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.

Achieving Advance Care Planning In Diverse Populations Via Teleconferencing With Skilled Nursing Facility Residents, Tania Huezo

Doctor of Nursing Practice Final Manuscripts

Background: Advance care planning (ACP) has always been a priority in healthcare, and even more crucial during the COVID-19 pandemic. It has been extremely challenging for ACP to occur in the skilled nursing facility (SNF) population once social distancing restrictions were put in place to protect residents and staff.

Purpose: The purpose of this evidence-based project was to assess the effectiveness of ACP via teleconferencing with skilled nursing facility (SNF) residents in the hope of increasing completion of high-quality Physician’s Orders for Life-Sustaining Treatment (POLST) forms.

Methods: The San Diego Coalition for Compassionate Care developed an ACP community outreach program …

Increasing Physical Activity In Children And Adolescents During The Covid-19 Pandemic, Alyssa Plisic

Doctor of Nursing Practice Final Manuscripts

Exercise benefits physical and mental health, prevents chronic disease, and improves overall quality of life. Most children and adolescents do not meet daily physical activity recommendations (Child and Adolescent Health Measurement Initiative, 2019). The COVID-19 pandemic created large barriers for engagement in exercise and further decreased levels of activity in this population (Dunton et al., 2020; Moore et al., 2020; Sekulic et al., 2020). This project evaluates the effects of the COVID-19 pandemic on physical activity in youth 8-17 years old. An exercise journal increased activity in all participants and promoted attention to daily activity. Overall activity and participation in …

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …

The Ripple Effect: ‘Training The Trainer’ On The Impact Of Body Image Through A Dance/Movement Therapy Technique, Marina Gearhart

Expressive Therapies Capstone Theses

This thesis describes the capstone project which was a psychoeducation and experiential workshop for fitness trainers. The workshop investigated the impact trainers’ work may have on the body image of their clients through a dance/movement therapy (DMT) technique. The aim was to enhance the trainers’ sensitivity around body image issues of their clients and to create a space for vulnerable movement conversation that may in turn lead to better mental health advocacy for their clients within the scope of ethical practice. The participants of the workshop were six white female identifying trainers ranging from 24 to 35 years of age. …

Exploring Art Therapy With Clients Suffering From Eating Disorders In An Out-Patient Setting, Miranda Hays

Expressive Therapies Capstone Theses

To date no peer reviewed literature has been published using art therapy for the treatment of clients with eating disorders (EDs) in an outpatient treatment setting. Despite evidence-based treatment methods being used to help treat clients with EDs high rates of morality and relapse persist for clients with EDs (Belak, 2017, p.1). There is a need for creative approaches to ED treatment that can be used to enhance existing evidence-based treatment models. Art Therapy can provide clients with EDs the opportunity to engage in the creative process which allows them to momentarily lessen their defense mechanisms and explore their ED …

The Use Of Role Theory And Method To Support Expanding College Athletes Role Repertoire: A Literature Review, Danielle Gervais

Expressive Therapies Capstone Theses

College student athletes tend to prioritize the role of athlete versus the role of student due to positive early life responses to their athletic pursuits (Menke & Germany, 2019). When the collegiate athlete then retires and/or graduates, they are at an increased likelihood of suffering negative psychological symptoms and/or an identity crisis now that the role of athlete is no longer relevant to their identity. Drama therapy’s role theory and method, an embodied form of therapy that focuses on identity formation and development in a less verbal and more expressive way, could potentially be used as a preventative treatment in …

Flexibility And Fusion: A Method To Expand The Window Of Tolerance For Clients With Eating Disorders, Mimi Richmond

Expressive Therapies Capstone Theses

Due to the complex etiology and treatment challenges of eating disorders, researchers continue to explore multidisciplinary, experiential approaches that target the experiential avoidance and psychological inflexibility that are often at the heart of the disorders’ resistant nature. With flexibility woven into its core processes, drama therapy is an embodied and relational approach that is emerging as an effective treatment modality for this population. This project illustrates ways drama therapy can widen the windows of tolerance for clients locked in the rigidity of an eating disorder. A group therapy method which flips the traditional developmental progression of drama therapy interventions is …

Nothing To Lose: A Literature Review On Combating Anti-Fat Bias Through Expressive Therapies, Katlyn Tracy

Expressive Therapies Capstone Theses

Anti-fat bias exists and is a pervasive and often overlooked form of oppression that significantly harms the mental health of fat people. Similar to other forms of oppression, anti-fat bias remains perpetuated through ideology, enforced institutionally through discriminatory practices, and enacted through interpersonal harassment. There is growing interest in exploring not only the mental health impacts of anti-fat bias, but also the development of effective therapeutic interventions to support fat people impacted by it. However, research on therapeutic strategies for combating this issue remains scarce. The field of Expressive Therapies, with its range of creative modalities and focus on engaging …

The Integration Of Tbri & Expressive Therapies Continuum: In-Home Expressive Arts Interventions For Foster And Adoptive Families During Covid-19, Jill Stockburger

Expressive Therapies Capstone Theses

With the onset of COVID-19 and the necessary isolation of a global pandemic, the therapeutic space was forced to redefine itself within the virtual realm as the ripple effect of collective trauma further compounded families healing from complex or relational trauma. Clinicians were virtually invited more into participants’ living spaces and interdependence with interpersonal family dynamics through this evolution. By combing the evidence-based practice of Trust-Based Relational Interventions with the framework of the Expressive Therapies Continuum, a more expansive, embodied, and uniquely client-centered, neurologically developmental approach emerged that engaged the healing potential of the caregiver-child relationship through increased co-regulation and …

Art Therapy With Children And Adolescents Experiencing Obesity: Embracing An Object Relations Approach, Rohan Roberts Goldman

Expressive Therapies Capstone Theses

This thesis looked at how art therapy can help identify problems in attachment between children and adolescents living with obese bodies and their parents. In this literature review, I examined the dynamics of child-parent/caretaker relationships and the way object relations and attachment play a significant role in the child’s mental health development. Incorporating art therapy into the treatment for this population has shown some signs of improving the dynamic between children and their caretaker. Through this research, I concluded that children need a consistent caregiver to be attuned to their needs. If they lack attuned and consistent care, the child …

A Literature Review On Expressive Dance/Movement Therapy Supporting Mental Health And Menstruation, Chantal Nathalie Bañuelos-Atienza

Expressive Therapies Capstone Theses

The aim of this thesis is to inform and showcase the importance of Expressive Dance/Movement Therapy Supporting Mental Health and Menstruation. Through the extensive search for data the writer found a gap in current treatment options that do not utilize the benefits of Expressive Dance/Movement Therapy and or Creative Arts as a treatment option for womxn suffering from Premenstrual Symptoms (PMS), Premenstrual Exacerbation (PME) and or Premenstrual Dysphoric Disorder (PMDD). By using case studies that support Expressive Dance/Movement Therapy as a theoretical framework to demonstrate the effects of mindfulness, emotional benefits of creative arts, and cultivating embodiment of sensual empowerment. …

Storytelling As An Expressive Arts Therapy Intervention With Children Via Telehealth, Sidney Marie Joines

Expressive Therapies Capstone Theses

As an expressive arts therapist in training working in the midst of a global pandemic, I sought to develop a creative, safe, accessible, and effective intervention for children via telehealth during a time of great uncertainty. Coronavirus 2019 has had a massive impact on mental and physical health and disrupted the lives of billions across the globe; the pandemic also forced mental health professionals to online formats. I found a significant lack of literature around expressive arts therapy via telehealth. Through considering theoretical approaches from cinematherapy, narrative therapy, metaphor therapy, play therapy, and expressive arts therapy, I developed an eight-week …

Optimizing Treatment For Preterm Infants Through Music Therapy: A Critical Review Of Literature, Lauren Ciccarelli

Expressive Therapies Capstone Theses

This capstone thesis explores music therapy treatment for preterm infants in the neonatal intensive care unit. The first section outlines developmental considerations and interventions for preterm infants which include minimizing stress, prioritizing sleep, developing feeding behaviors, and promoting strategies for self-regulation of the infant. Both standard care and music therapy interventions are included in this discussion. The second section includes considerations and interventions for attachment and social development. These include skin- to-skin contact between infant and caregiver, the importance of emotional closeness in the infant-caregiver relationship, and supporting parents as they interact with their child in the hospital environment. The …

Three Essays On Climate Change Adaptation In Rural African Communities, Hannah Patnaik

Dissertations - ALL

Climate change is one of the defining challenges of the present era, bringing new risks and exacerbating existing vulnerabilities across the world. While there is a broad recognition that solutions around climate change will require coordination and support across borders and governments, a large body of scholarship has focused on the local-level realities of climate change and the disproportionate impacts on the most vulnerable populations. The climate vulnerable poor do not have the privilege of waiting for global policy and commitment to emission reduction targets. They need planned and proactive adaptation support to build resilience to the changing climate and …

The Impact Of Mindfulness On Healthcare Provider Burnout During Covid-19, Natasha Johnson

Mindfulness Studies Theses

Healthcare providers are subject to unique stress as part of their job in a helping profession and regularly suffer the effects of burnout and secondary traumatic stress. Mindfulness-based interventions have been demonstrated to be effective in reducing burnout and addressing the impacts of secondary traumatic stress, however the current COVID-19 pandemic poses a new, more debilitating type of stress to healthcare providers. This paper seeks to examine the existing evidence on the effects of mindfulness in reducing burnout and secondary traumatic stress, incorporate new evidence on the unique stress of COVID-19, and determine if mindfulness interventions remain effective. It also …

Mindfulness Practices For Women’S Midlife Transition, Patricia A. Chilangwa

Mindfulness Studies Theses

Every major period of life brings a unique set of opportunities and challenges. Midlife remains a mostly uncharted territory in the field of human development. Given that women of middle age currently comprise over 17 % of the total population, it is essential that we seek a better understanding of middle age and what may or may not be beneficial during this stage of life. The purpose of this work is to present a supportive academic rationale paper and a creative project consisting of a book with a journal component on mindfulness practices for finding ease and grace in the …

Emergency Department Visits And Hospital Admissions For Adult Cancer Patients Post Outpatient Chemotherapy: Does The Oncology Nurse Navigator Make A Difference?, Sunny L. Stirling

Dissertations

Background: Cancer is the second leading cause of death in the United States and worldwide. Oncology related hospital visits account for over $88 billion annually; 35% of this cost is attributable to inpatient hospital stays even though most cancer treatments are given outpatient. The Centers for Medicare and Medicaid Services introduced the Chemotherapy Measure which tracks Emergency Department visits and hospitalization within 30 days of any outpatient chemotherapy treatment. The Oncology Nurse Navigator (ONN) has offered some benefit in cancer care, but its role in ED visits and hospital admissions is unknown for adult patients with cancer post outpatient …

Food Insecure Copd Patients And Healthcare Utilization: A Retrospective Study, Kristine Mendoza

Dissertations

Abstract

Purposes/Aims: Despite advances in the recognition and treatment of high-cost users of health care, the incidence of healthcare utilization remains high. Rates of hospital admissions and emergency room visits among chronic disease like COPD have become a targeted group for health management. COPD patients have multiple and complex health and social needs, but the impact of their unmet food needs is not well understood and warrants further investigation. The purpose of this study is to explore the relationships between COPD food insecure patients and healthcare utilization in San Diego County.

Background/Rationale: Government programs targeting patients with high healthcare costs …

The Effects Of Whole Genome Duplication On Functional Traits And Interactions With Arbuscular Mycorrhizal Fungi, Thomas Anneberg

Dissertations - ALL

Whole genome duplication is one of the most pervasive forces driving plant evolution, yet modelling efforts on the establishment of polyploid plants have shown that early generation polyploids, or “neopolyploids”, should experience high extinction rates due to a population demographic disadvantage. A major gap in understanding why established polyploids are so prevalent despite theoretically high extinction rates is that we know so little about the ecological consequences of neopolyploidy. For example, by investigating how neopolyploidy affects plant ecophysiology, or functional trait variation across environments, we can understand the ecological contexts that can promote polyploid establishment. Thus, a major goal of …

Comparision Of Chemical Composition And Nutritive Value Of Rangeland Plants In Northern Iran, Nafise Jalali, M. Shokri, H. Zali, G. H. Heidari

IGC Proceedings (1977-2023)

No abstract provided.

Implementing And Evaluating Health Behavior Changes, Robert E. Davis

Diet, Food, Exercise, and Nutrition (D-FEND)

Describes what health, health behavior and health behavior change mean and how to take action to create a health behavior change for yourself.

Self-Administered Cognitive Screening To Monitor For Cognitive Side Effects From Outpatient Electroconvulsive Therapy, Peter Holguin, Christopher Abbott

Quality Improvement/Patient Safety Symposium

Abstract: Electroconvulsive therapy (ECT) is a rapid and effective treatment for multiple types of mental illness including major depressive disorder, bipolar depression, and catatonia. ECT can result in multiple cognitive side effects including post-ECT delirium as well as anterograde and retrograde amnesia. Administering formal cognitive screening at baseline, during, and after completion of ECT could be an effective means of monitoring for cognitive side effects from ECT. Conducting cognitive screening in an outpatient ECT service poses multiple challenges including time, limited staff, and availability of trained staff to administer cognitive screening. After reviewing multiple cognitive screens, the Self-Administered Gerocognitive Examination …

Preventing Central Line Associated Bloodstream Infections In An Adult Intensive Care Unit, Monica Shaw

Master's Projects and Capstones

Central line associated blood stream infections (CLABSI) are considered preventable healthcare acquired infections, and are associated with significantly increased morbidity, mortality, and length of hospital stay. The CLABSI rate in an inpatient unit is a meaningful metric in relation to the safety and quality of care in that microsystem. This quality improvement project examines the efficacy of a CLABSI prevention bundle in reducing CLABSI events and improving adherence to central line care policy within a medical surgical adult intensive care unit. The target areas the bundle aimed to improve were unit processes, awareness of CLABSI and central line policies, and …

It’S Their Lifeline: Preventing Central Line Associated Blood Stream Infection In An Adult Intensive Care Unit, Jacenda Lee Rangel

Master's Projects and Capstones

Problem description: Central line associated blood stream infection (CLABSI) is one of the deadliest types of hospital acquired infection and blood stream infection, raising patient mortality by 12-25% and accounting for 28,000 deaths annually in the United States. CLABSI also increases morbidity, length of stay, and costs hospitals an average of $48,000 per case. Effective measures for CLABSI prevention are needed for an adult intensive care unit (ICU) of an urban hospital to decrease the financial burden of CLABSI, improve quality of care, and prevent patient harm.

Setting: The microsystem of focus is a 36-bed high acuity ICU. Patients of …

Assessing How Equity Plays A Role In Climate Change Adaptation In Urban Cities With Regards To Water, Energy, And Food, Evelyn Ramon

Master's Projects and Capstones

With two-thirds of the population living in cities by 2050 and projected climate change impacts, urban cities can facilitate the transition to more sustainable and resilient cities. I conducted a comparative analysis for three cities in California to evaluate their priorities in their Climate Action Plans. I used the United Nations Sustainable Development Goals as a framework for comparing their progress. According to the 2019 Sustainable Development Goals Index, San Francisco was the city that performed the best by including climate change adaptation and mitigation strategies. Their understanding of climate change impacts allowed them to prioritize their resources to build …

Planting Seeds For Success: An Evaluation Of Agricultural Reentry Programming For Formerly Incarcerated Individuals, David J. Jefferson

Master's Projects and Capstones

Black and brown communities are over-incarcerated and are much more likely than their white counterparts to be involved with the criminal justice system. Hundreds of thousands of incarcerated people are released each year and they face substantial barriers to reentry such as lack of employment opportunities, difficulty securing housing, accessing education, and just simply reintegrating back into society. The criminal justice system within the United States is fueled by systemic racism and overt discrimination towards people of color, and the same can be said for the food system within the United States as well. They share a history of oppressive …

Construction Of Dichotomous Taxonomic Keys For San Francisco Bay Planktonic Diatoms, Ria Angelica Laxa

Undergraduate Honors Theses

Planktonic diatoms exhibit high biodiversity in marine systems and make a significant contribution to water column primary productivity. This makes research on planktonic diatoms particularly important in measuring the health of coastal marine ecosystems. At the University of San Francisco (USF), undergraduate research has been conducted since September 2015 to study planktonic diatoms in San Francisco Bay. A previous study by Keith (2018), Planktonic Diatom Species Succession in San Francisco Bay, documented changes in species diversity over time, observing seasonal patterns in species richness as well as the effect of environmental factors such as salinity, temperature, and rainfall on species …

Neo-Extracting Gilded Welfare States: A Comparative Study Of Extractivism And Latin American Welfare State Formation, Pabvitraa Ramcharan

Student Theses and Dissertations

This paper attempts to establish a stronger linkage between neo-extractivism and social welfare states in contemporary Latin America using both a micro and macro perspective. By emphasizing the human capital aspect of the welfare state’s role in promoting equitable redistribution and correcting market failures, this paper attempts to evaluate the extent to which extractive industries contribute to human capital formation. Due to the sectors’ large influence on the state and weak capacity to create employment, I develop the concept of the “gilded welfare state,” defined by the inability of extractive industries to ensure equal opportunity and generate formal employment despite …

Implementation Of Dietary Methionine Restriction Using Casein After Selective, Oxidative Deletion Of Methionine, Han Fang, Kirsten P. Stone, Laura A. Forney, Landon C. Sims, Gabriela C. Gutierrez, Sujoy Ghosh, Thomas W. Gettys

Division of Basic Science Faculty Publications

Dietary methionine restriction (MR) is normally implemented using diets formulated from elemental amino acids (AA) that reduce methionine content to ∼0.17%. However, translational implementation of MR with elemental AA-based diets is intractable due to poor palatability. To solve this problem and restrict methionine using intact proteins, casein was subjected to mild oxidation to selectively reduce methionine. Diets were then formulated using oxidized casein, adding back methionine to produce a final concentration of 0.17%. The biological efficacy of dietary MR using the oxidized casein (Ox Cas) diet was compared with the standard elemental MR diet in terms of the behavioral, metabolic, …