Medicine and Health Sciences Commons^™

Anger And Posttraumatic Stress Disorder Symptom Severity In A Trauma-Exposed Military Population: Differences By Trauma Context And Gender, Miranda Worthen, Sujit Rathod, Gregory Cohen, Laura Sampson, Robert Ursano, Robert Gifford, Carol Fullerton, Sandro Galea, Jennifer Ahern

Faculty Publications

Studies have found a stronger association between anger and posttraumatic stress disorder (PTSD) severity in military populations than in nonmilitary populations. Two hypotheses have been proposed to explain this difference: Military populations are more prone to anger than nonmilitary populations, and traumas experienced on deployment create more anger than nondeployment traumas. To examine these hypotheses, we evaluated the association between anger and PTSD severity among never-deployed military service members with nondeployment traumas (n = 226) and deployed service members with deployment traumas (n = 594) using linear regression. We further examined these associations stratified by gender. Bivariate associations between anger …

Impact Of Adverse Childhood Experiences On Intimate Partner Violence Perpetration Among Sri Lankan Men, Ruvani W. Fonseka, Alexandra M. Minnis, Anu Manchikanti Gomez

Faculty Research, Scholarly, and Creative Activity

In Sri Lanka, over one in three women experience intimate partner violence (IPV) victimization in their lifetime, making it a serious public health concern. Adverse childhood experiences (ACEs) such as child abuse and neglect, witnessing domestic violence, parental separation, and bullying are also widespread. Studies in Western settings have shown positive associations between ACEs and IPV perpetration in adulthood, but few have examined this relationship in a non-Western context. In the present study, we examined the association of ACEs with IPV perpetration among Sri Lankan men surveyed for the UN Multi-Country Study on Men and Violence in Asia and the …

The Challenges Of Afghanistan And Iraq Veterans’ Transition From Military To Civilian Life And Approaches To Reconnection, Jennifer Ahern, Miranda Worthen, Jackson Masters, Sherri Lippman, Emily Ozer, Rudolf Moos

Faculty Publications

Afghanistan and Iraq veterans experienced traumas during deployment, and disrupted connections with friends and family. In this context, it is critical to understand the nature of veterans’ transition to civilian life, the challenges navigated, and approaches to reconnection. We investigated these issues in a qualitative study, framed by homecoming theory, that comprised in-depth interviews with 24 veterans. Using an inductive thematic analysis approach, we developed three overarching themes. Military as family explored how many veterans experienced the military environment as a “family” that took care of them and provided structure. Normal is alien encompassed many veterans experiences of disconnection from …

Mobile Health-Care Information For All: A Global Challenge, Geoff Royston, Christine Hagar, Lesley-Anne Long, Dennis Mcmahon, Neil Pakenham-Walsh, Nand Wadhwani

Faculty Publications

Access to health-care information for citizens is a key determinant to reach both the Millennium Development Goals (MDGs) and the emerging post-2015 Sustainable Development Goals, but this challenge has repeatedly been relegated to the sidelines.1 What might kickstart progress? An obvious candidate is the mobile phone, which is becoming ubiquitous in low-income and middle-income countries.

Short Report: Raising Children Bilingually, Henriette Langdon

Faculty Publications

The purpose of this article is to describe the process of becoming bilingual by sharing my own experience being raised in a four-language environment and how it influenced the upbringing of my daughter in two, and subsequently three languages. The other purpose is to dispel the myth that children with language, developmental and/or intellectual impairments or those diagnosed as being on the autism spectrum cannot or should not be exposed to two languages because it is confusing, or because they simply cannot handle two languages due to their disability. As a bilingual speech and language pathologist (SLP) who has practiced …

What Does The Time Constant Of The Pulmonary Circulation Tell Us About The Progression Of Right Ventricular Dysfunction In Pulmonary Arterial Hypertension?, Alessandro Bellofiore, Z. Wang, Naomi Chesler

Faculty Publications

Compliance (C) and resistance (R) maintain a unique, inverse relationship in the pulmonary circulation, resulting in a constant characteristic time that has been observed in healthy subjects as well as patients with pulmonary arterial hypertension (PAH). However, little is known about the dependence of right ventricular (RV) function on the coupled changes in R and C in the context of this inverse relationship. We hypothesized three simple dependencies of RV ejection fraction (RVEF) on R and C. The first model (linear-R) assumes a linear RVEF-R relation; the second (linear-C) assumes a linear RVEF-C relation; and the third one combines the …

Patient Access To Electronic Health Records: Strengths, Weaknesses And What’S Needed To Move Forward, Alicia V. Zuniga

School of Information Student Research Journal

Electronic health records (EHRs) are desired by both physicians and patients, but the transition to and acceptance of sensitive health information online has been slow. This paper reviews the current literature on EHR adoption and outlines barriers, advantages and explicit steps for moving toward the EHR ubiquity. Potential benefits of EHRs to patients and physicians include reduced costs for patients, hospitals and insurance providers, patient empowerment, less errors in records and better health outcomes, but security and privacy concerns, cost of implementation and poor electronic records management system design have proved barriers to adoption.

University Scholar Series: Ed Cohen, Edward Cohen

University Scholar Series

Mental Health and Cultural Context in Vietnam

On May 6, 2015, Dr. Ed Cohen spoke in the University Scholar Series hosted by Provost Andy Feinstein at the Dr. Martin Luther King, Jr. Library. In this presentation, Dr. Cohen explored current research about mental illness and approaches to treatment in Vietnam, in addition to this country’s world view about illness, wellness and emotional health. Cohen is an Associate Professor in the School of Social Work and a Co-Investigator of SJSU's Social Work Education Enhancement Program in Vietnam.

Guilty By Reason Of Insanity: Unforeseen Consequences Of California's Deinstitutionalization Policy, Jen Rushforth

Themis: Research Journal of Justice Studies and Forensic Science

Beginning with the passage of the Lanterman-Petris- Short Act in 1969, deinstitutionalization in California has had a devastating effect on the mentally ill. Instead of affording the mentally ill with more rights and protections, the process of shutting down state psychiatric hospitals and impeding psychiatric care for those in need caused a cascade effect leading to an increase of homelessness and incarceration. Over the past four decades, prisons and jails in California have become the de facto state mental hospitals, with severely mentally ill individuals having nearly a four-to-one chance of ending up in jail or prison over a psychiatric …

The Use Of Criminal Profilers In The Prosecution Of Serial Killers, Chelsea Van Aken

Themis: Research Journal of Justice Studies and Forensic Science

The purpose of this paper is to analyze the concept of criminal profiling in terms of serial killers in the United States. The research provided in this paper was found using the most recent research available on the topic. The FBI’s Behavioral Unit, or National Center for the Analysis of Violent Crime (NCAVC), is the current leading law enforcement agency that investigates these types of crimes. They utilize definitions, typographies, and motives to create a criminal profile to investigate serial killings. Ultimately, these profiles are inadequate because they are inconclusive and exclude multiple suspects that are potentially dangerous. Therefore, criminal …

Frontal Lobe And Psychopathy, Shawna Germain

Themis: Research Journal of Justice Studies and Forensic Science

This research paper presents an analysis of the functions of the frontal lobe and how damage to the frontal lobe correlates to psychopathy. Initially, it will look at how damage to the frontal lobe obstructs frontal lobe functions. The decrease in executive function, due to a reduction of blood flow to the frontal lobe following a subarachnoid hemorrhage, is explored. The correlation between cortical thickness and impulsiveness in adolescence is examined. Subsequently, the issue is then examined through the observation of groups with psychopathy and how the diagnosis relates to their frontal lobes. One study compares individuals with psychopathy to …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Nurses Caring For Adults With Autism In An Emergency Department: A Survey Of Knowledge, Shauna Marie Miller

Doctoral Projects

Autism is a complex neurodevelopmental disorder characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. The nurse (RN) in the emergency department (ED) plays an important role in the receiving, treatment, and management of the patient with autism. RNs must understand the unique challenges of caring for individuals with autism. Fortunately, autism is an active area of research, with copious resources available to assist those affected by this disorder; however, no studies were found evaluating nurses’ knowledge of autism and the number of resources for nurses caring for this population was limited. Nursing is an …

The Pupillometer In Practice: Identifying And Overcoming Barriers, Audrey Lee Paulson

Doctoral Projects

Problem: The pupillometer is an assessment tool that provides an accurate assessment of pupil reactivity. It is appropriate for patients who are neurologically impaired due to injury or illness. This tool, available and in use at a local community hospital, has minimal perceived importance in the Neuroscience Intensive Care Unit (NSICU), due to a disconnect experienced by the staff. The hypothesis was that understanding the pupillometer information was insufficient and that improving the knowledge would increase the perception of usefulness. Method: Conduct a survey to determine the cause of the lack of interest and use of the pupillometer. Once the …

Identifying Factors In Medication Non-Adherence In Teens Diagnosed With Juvenile Arthritis: A Pilot Study, Susan Viola Senzaki

Doctoral Projects

Purpose: The purpose of this study was to identify factors that correlate with medication non-adherence in teens diagnosed with juvenile arthritis. Background: The impact of medication non-adherence often begins in childhood where children depend and learn from their care-givers how to manage their health. Children with chronic disorders are among those at risk for a higher medication non-adherence. Juvenile arthritis (JA) is a chronic childhood disorder where often medication non-adherence is an issue. Methodology: This was a mixed-method qualitative and quantitative pilot study. Teens between the ages of 11 – 17 years, with juvenile arthritis were asked to volunteer in …

Outcome Analysis And Quality Improvement For Inter-Hospital Transfers Of Pediatric, Carma Lynn Tobiassen

Doctoral Projects

Pediatric patients who initially present to a community hospital setting can be adequately cared for the majority of the time, in the emergency department (ED), on the pediatric ward (PEDS), and the post anesthesia care unit (PACU). When a pediatric patient is in need of specialized care or is decompensating and becomes critically ill, initial medical stabilization is required and the identification of a critical care bed and admitting physician are needed in a timely manner. Inter-hospital transfers (IHT) of pediatric patients are frequent occurrences, as more and more areas are consolidating their resources and Pediatric Intensive Care beds are …

Implementation Of A Patient Satisfaction Survey In A Federally Qualified Health Center, Ricardo Jose Ballin Ii

Doctoral Projects

Safety net FQHCs are typically challenged with initiating and sustaining standardized measurement of patient satisfaction. Baseline survey data establishing how patients rate their satisfaction at San Francisco General Hospital (SFGH) Urgent Care Center (UCC), a public safety net federally qualified health center, located in San Francisco, California is needed. Implementing an existing patient satisfaction survey instrument using a standardized method, with volunteer survey administrators, made this study unique and resulted in a higher rate of survey participation that any other method previously attempted. Survey results determine whether patients' needs and expectations were being met, adding value and allowing for comparison …

Improve Intra-Operative Nurse-To-Nurse Communication Using A Safety Checklist, Silvinita Tadeo Rowe

Doctoral Projects

Poor and inadequate handoff, or transfer of care of the surgical patient care from the primary to the relief operating room registered nurse circulators, can result in irreversible patient harm, or sentinel events, such as retained foreign items. In this study, Rogers' diffusion of innovation theory was the framework for implementing the handoff safety checklist. Also, Donabedian's structure process and outcome was the model to investigate the feasibility, acceptability, and improvement in the quality of patient handoff communication and improvement of nurse satisfaction over time. Nineteen-statement surveys, conducted at multiple timeframes, were completed by volunteer operating room nurse participants. In …

The Effectiveness Of A Standardized Positioning Tools And Bedside Education On The Developmental Positioning Proficiency Of Nicu Nurses, Arlene Spilker

Doctoral Projects

Developmental positioning for preterm infants is an essential skill for neonatal intensive care unit (NICU) nurses. The benefits of developmental positioning are evident in the literature, but less is known about how NICU nurses learn about developmental positioning. This study examined the effect of the Infant Position Assessment Tool (IPAT) and informal education on the developmental positioning skills of NICU nurses. This quasi-experimental study measured IPAT scores before and after an educational intervention, and found a statistically significant increase in the means of the two groups. The use of the IPAT and bedside education is useful for improving the developmental …

Factors Leading To Rapid Response Team Interventions In Adult Medical-Surgical Patients, Christine M. Tarver

Doctoral Projects

Rapid Response Team Intervention (RRTI) is a widely used intervention in acute care hospitals in the United States. Demonstrated effectiveness in preventing transfer to higher level of care or in decreasing in-hospital mortality has not been established. This exploratory study used a retrospective chat1 review to examine differences between medical-surgical acute care inpatients who had an RRTI and a control group. CutTent literature lacks information on proactive detection of patients who may be more likely to deteriorate and therefore require a Rapid Response Team Intervention. Therefore, this study's PICO question was: Are there statistically significant differences between medical-surgical adult inpatients …

Heath Care Providers’ Perceptions Of The Reproductive Challenges And Experiences Among Asian Indian Women Living In Silicon Valley, Olga Alexandra Libova

Doctoral Projects

Objective: To identify common reproductive challenges among Asian Indian (AI) women living in Silicon Valley as perceived by healthcare providers (HCP). Design: A 71-item investigator-developed survey Setting: The survey was available on-line to all HCPs in California Santa Clara county, 75% of respondents were affiliated with El Camino Hospital Mountain View. Participants: Convenience sample of 78 respondents: 34% mother-baby nurses, 24% labor-delivery nurses, 21% OB/GYNs, 7% CNMs, 14% other HCP; 89% female; 55% Caucasian, 24% Asian. Methods: Likert-type scales comparing prevalence of certain reproductive challenges among AI women and women from other race-ethnic groups and openended questions regarding HCPs’ experience …

Chinese Community Physicians' Perception Toward Collaboration With Advanced Practice Nurses, Ivy Tan

Doctoral Projects

Effective interprofessional collaboration has been shown to be beneficial for both patients and providers. Yet collaboration between physicians and advanced practiced nurses (APNs) has been problematic. Little was known about such collaboration in an ethnic group like the Chinese community. This quantitative descriptive capstone project was to assess the perception among physicians, who are the members of the Chinese Community Healthcare Association in the San Francisco area, toward collaboration with APNs. The study also attempted to gain insight of collaborative attitudes of physicians in the Chinese community in order to fill the gap in the literature in this area. Data …

Developing A Patient Care Standard For Adolescents Based On A Nursing Needs Assessment, Kathryn Blake

Doctoral Projects

Mental health patients often suffer from chronic medical conditions and psychiatric comorbidities requiring frequent emergency, primary care, and acute care visits (Douzenis et al., 2012). Caring for psychiatric patients in acute care hospitals has become an increasing burden on healthcare systems with processes in place to care for acute and critical care patients. Healthcare leaders, providers, emergency departments, and medical/surgical hospitals are straining to provide care for complex patients with acute medical conditions and complex mental health needs (Reiss-Brennan, Briot, Savitz, Cannon, & Staheli, 2010). Caring for children and adolescents with medical and psychiatric problems creates the need for a …

A Comparison Of Pedagogical Approaches To Error Communication Training, Marie Annette Gilbert

Doctoral Projects

Purpose: The purpose of this study was to compare the effectiveness of two different pedagogical approaches to error communication training.

Background: The literature advocates full, transparent communication following a medical error. However, many barriers to such disclosure exist. A significant barrier is healthcare providers do not feel prepared for these difficult conversations. This can be particularly challenging in a pediatric setting when the conversation with a parent may be more demanding than similar conversations in the non-pediatric settings.

Method: Individuals from three different professional groups were recruited; physicians, pharmacists, and nurses. A randomized controlled study was conducted to investigate …

Admission Medication Reconciliation Process To Improve Patient Outcomes, Vanessa Ann Irwin

Doctoral Projects

Medication reconciliation is an important process in the acute care setting that has implications for patient safety and outcomes. The medication reconciliation process occurs at transitions in care and involves disciplines including; nurses, pharmacists, and physicians. The role of the nurse in the admission portion of the process includes collecting and entering home medication information into the electronic medical record. It is crucial for the medication information to be entered in an accurate, timely, and complete manner.

The addition of the electronic medical record has not solved documentation challenges related to medication reconciliation but has added more transparency of issues. …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

Pain Management At End Of Life When There Is A Co-Occurrence Of Substance Use Disorder: A Qualitative Metasynthesis, Kristina Olfson

Doctoral Projects

Pain management, end of life (EOL) care, and substance use disorder (SUD) are individually identified as National healthcare challenges and priorities. Despite 50 years of advances in the understanding of pain management, pain is still inconsistently assessed and undertreated in all populations, including those with life limiting illness. When a patient with a life limiting illness and history of SUD is encountered, pain management becomes further complicated. Effective pain management for all patients, regardless of coexisting complications, is an ethical obligation of health care providers. Given the lack of research into EOL pain management of patients with SUD, it is …

Commercial Sexual Exploitation: The Role Of The Advanced Practice Nurse In Screening Patient At-Risk, Sheri Rickman Patrick

Doctoral Projects

Problem: Human trafficking or commercial sexual exploitation (CSE) is a global problem effecting every country including the United States. The impact of human trafficking while it is devastating to individuals, the impact goes well beyond individual victims and undermines the health, safety and security of all nations (U.S. Department of State Publication, 2007, p. 5).This research is an attempt to assess the knowledge of advance practice nurses or nurse practitioners (NP) in the subject of commercial sexual exploitation and their willingness to screen their patients who may be at-risk.

Methods: The design was web-based with advanced practice nurses who are …

Exploring College Students' Perceptions Of College Gun Violence: A Meta-Analysis, Julia Chaw Chih Lee

Doctoral Projects

College gun violence has been one of our nation’s most forefront issues in recent years. The present meta-analysis reviewed studies reporting college students’ perceptions about school/college gun violence in order to summarize the total effect and direction of these research findings. There were only two studies identified for this research topic: Study A and Study B. Combining the effect sizes from both studies could not be accomplished because there was not enough data from Study A to calculate the correlation coefficient(r) or standardized mean difference (SMD). The summary of the results of the two studies as a metaanalysis was more …

Bio-Identical Hormones Utilized For Treating Menopausal Symptoms: Are They Safe?, Maria D. White

Doctoral Projects

The use of compounded bioidentical hormones in the various forms of gels, creams, and troches has increased in popularity. The population of menopausal women is at a crossroads with the cascade of symptoms and determining what are their options. The Endocrine Society, the Food and Drug Administration, and the National Menopause Society do not support the use of bioidentical hormones, despite the support for bioidentical hormone replacement therapy (BHRT) by the American Academy for Anti-Aging Medicine and other proponents for BHRT. The literature review reveals the need for studies documenting the safety of BHRT. The objective for this study was …