Medicine and Health Sciences Commons^™

Mers-Cov Infection In South Korea And Strategies For Possible Future Outbreak: Narrative Review, Chulwoo Park

Faculty Publications

Although there were some positive viewpoints from international press and academia that the Republic of Korea (hereafter South Korea) successfully controlled the Middle East Respiratory Syndrome (MERS) outbreak in 2015, the domestic point of view towards the MERS response in South Korea was critical. As people in the world’s 11th largest economy, South Koreans criticized the failure of hospitals’ initial response to the MERS index case and the lack of a proper control strategy for secondary and tertiary cases. To contain the MERS outbreak, South Korea implemented mainly three MERS control and intervention strategies: quarantine and isolation system, temporary closure …

What Is Clinician Presence? A Qualitative Interview Study Comparing Physician And Non-Physician Insights About Practices Of Human Connection, Cati Brown-Johnson, Rachel Schwartz, Amrapali Maitra, Marie Haverfield, Aaron Tierney, Jonathan Shaw, Dani Zionts, Nadia Safaeinili, Sonoo Thadaney Israni, Abraham Verghese, Donna Zulman

Faculty Publications

Objective We sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts.Design In 2017–2018, we conducted qualitative semistructured interviews with 10 physicians and 30 non-medical professionals from the fields of protective services, business, management, education, art/design/entertainment, social services, and legal/personal services.Setting Physicians were recruited from primary care clinics in an academic medical centre, a Veterans Affairs clinic, and a federally qualified health centre.Participants Participants were 55% men and 45% women; 40% were non-white.Results Qualitative analyses yielded a definition of …

Using The Clinical Frailty Scale To Predict The Length Of Stay In Otolaryngology Unit In Taiwan, Wei-Kang Tung, Hsiang-Chin Hung, Wei-Chen Tung

Faculty Publications

Frailty was a common syndrome in geriatric clinic and general internal medical wards. Some authors had identified the Clinical Frailty Scale (CFS) as a predictor of length of stay in the acute medicine unit. However, the role of the Clinical Frailty Scale in the length of stay in otolaryngology unit had not been well studied. The objective of this study was to find out the correlation of the CFS in elderly patients admitted to otolaryngology unit and their length of stay. A retrospective medical chart review of 203 elderly patients admitted to the otolaryngology ward from January, 2014 to December, …

Exploration Of Factors Associated With Perceived Barriers To Cervical Cancer Screening Among Chinese American Women, Wei-Chen Tung, Minggen Lu, Michelle Granner, Jiani Mcdonough, Susan Ervin

Faculty Publications

This study explored factors associated with perceived barriers to Pap smear testing among Chinese American women (CAW). A total of 121 CAW, ages 21–65, living in California and Nevada completed a self-report questionnaire. Data included demographics, prior screening behavior, risk factors, and perceived barriers to screening. Logistic regression models revealed that participants with less education, and who have never been screened were more likely to report (I) worry about getting a Pap smear, (II) expense of a Pap smear, and (III) not knowing where to get a Pap smear. Partner’s resistance to the women’s participation in screening was another barrier …

Language Nutrition For Language Health In Children With Disorders: A Scoping Review, Janet Y. Bang, Aubrey S. Adiao, Virginia A. Marchman, Heidi M. Feldman

Faculty Research, Scholarly, and Creative Activity

The quantity and quality of child-directed speech—language nutrition—provided to typically-developing children is associated with language outcomes—language health. Limited information is available about child-directed speech to children at biological risk of language impairments. We conducted a scoping review on caregiver child-directed speech for children with three clinical conditions associated with language impairments—preterm birth, intellectual disability, and autism—addressing three questions: (1) How does child-directed speech to these children differ from speech to typically-developing children? (2) What are the associations between child-directed speech and child language outcomes? (3) How convincing are intervention studies that aim to improve child-directed speech and thereby facilitate children’s …

Medical Diaspora: An Underused Entity In Low- And Middle-Income Countries’ Health System Development, Seble Frehywot, Chulwoo Park, Alexandra Infanzon

Faculty Publications

Background

At present, over 215 million people live outside their countries of birth, many of which are referred to as diaspora—those that live in host countries but maintain strong sentimental and material links with their countries of origin, their homelands. The critical shortage of Human Resources for Health (HRH) in many developing countries remains a barrier to attaining their health system goals. Usage of medical diaspora can be one way to meet this need. A growing number of policy-makers have come to acknowledge that medical diaspora can play a vital role in the development of their homeland’s health workforce capacity. …

Social Support Networks And Symptom Severity Among Patients With Co-Occurring Mental Health And Substance Use Disorders, Marie Haverfield, Mark Ilgen, Eric Schmidt, Alexandra Shelley, Christine Timko

Faculty Publications

Patients entering an inpatient psychiatry program (N = 406) with co-occurring mental health and substance use disorders reported on their social support networks (source, type) at treatment intake, and completed symptom measures at baseline and 3-, 9-, and 15-month follow-ups (77%). Longitudinal growth models found aspects of participants’ support networks were associated with specific symptoms over time. Less family support (i.e., more conflict) was the most consistent predictor of mental health and substance use outcomes and was associated with greater psychiatric, depression, Post Traumatic Stress Disorder (PTSD), and drug use severity. More peer support (via mutual-help involvement) was associated with …

Cross-Cultural Lessons On Anger And Social Connectedness, Miranda Worthen

Faculty Publications

I first started thinking about anger and its role in the experiences of people who have fought in wars when I was in Sierra Leone, about a year after the cease-fire ended the civil war. I was working as a research assistant on a study with girls who had been child soldiers and who had given birth to children during the war. We were living in a community in the west, on the border with Guinea. At first, we met only a few young women. We listened to their stories—about the war, and about what life had been like for …

Educational Reinforcements Of And Challenges To Gender Norms In Urban Sri Lanka, Ruvani Fonseka

Faculty Research, Scholarly, and Creative Activity

Background:
In 2013, over half of surveyed Sri Lankan men and women expressed gender-inequitable attitudes equating masculinity with violence, and femininity with obedience to men. Gender-inequitable attitudes have been shown to be linked to gender-based violence (GBV) in multiple contexts.
The goal of this research was to identify points of intervention at which programmes and policies could cultivate gender-equitable attitudes among youth in Sri Lanka, with a goal of reducing GBV in adulthood.
Methods:
Over 9 months, the lead author interviewed 18 young adults (ages 18-30) in urban Sri Lanka to understand how their experiences influenced their gender identity, as …

Decomposition Of Pig Carcasses At Varying Room Temperature, Jacqueline Abad Santos

Themis: Research Journal of Justice Studies and Forensic Science

The goal of this study is to assess the qualitative scoring of decomposition scales with statistical analysis while also determining which indoor environment will decompose the fastest. When comparing the three indoor environments, water decomposition appears to be the fastest, but the method of analysis for this study determines that using decomposition scales to analyze such environments may produce statistically insignificant results. For this study, piglets were put in a dry steel tub, a water filled steel tub, and a suitcase. These were recorded using photographs for 25 days and then scored using decomposition scales. The total score was divided …

Comparing Two Surgical Outcomes: Minithoracotomy Or Full Sternotomy In Coronary Artery Bypass Grafting Surgery, Shirin Badrkhani

Doctoral Projects

Cardiovascular diseases and heart-related conditions can be life-threatening; however, some cardiovascular conditions can be managed with open heart surgery. Coronary artery bypass grafting (CABG) is the most common type of heart surgery performed on adults. There are two different surgical procedures to correct cardiac defects: mini-thoracotomy and full sternotomy. Mini thoracotomy approach has been shown to reduce complications, such as pneumonia, excessive blood loss, and infection in mitral valve repair surgeries. However, little research has been done to compare these two surgical approaches performed for patients undergoing coronary artery bypass grafting (CABG).

Specifically, there is inadequate data to compare these …

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Understanding The Skills Necessary For Advanced Practice Nurses In Oncology To Deliver Bad News To Patients With Cancer: The Results Of A Delphi Analysis, Matthew Michael Burke

Doctoral Projects

Overcoming the dichotomy of providing bad news in a compassionate, empathetic manner that strengthens dialogue and enhances a caring environment is the ultimate challenge advanced practice nurses (APN) face in oncology. This study aims to understand the skills necessary for APNs in oncology to deliver bad news to patients with cancer.

Using a Delphi analysis, an established method of developing a consensus, a novel, patient-centered survey tool has been developed designed to extract as much information as possible about the present issue from an expert panel. Oncology APNs were recruited via Facebook. The survey tool was administered using a web-based …

Comparison Of A Numeric And A Descriptive Pain Scale In The Occupational Medicine Setting, George Francis Mcmahon Iii

Doctoral Projects

Pain is a universal phenomenon. The assessment of a patient’s pain is difficult to objectively obtain because the perception of the pain by the patient is influenced by many subjective perception variables. These variables can inflate or deflate the patient’s self-reported pain level which can adversely affect the medical provider’s ability to accurately create a treatment plan for the patient. This study compared the patient’s response to a self-rating of their pain on a numeric pain scale with the response given by the patient on the Mankoski pain scale. Comparison of the numeric pain scale to the Mankoski pain scale …

Surgical First Assist: An Educational Program For Advanced Practice Providers, Sandra Walton Mobley

Doctoral Projects

As the number of surgical procedures increase, many Advanced Practice Providers (APPs) are being required to scrub in as a First Assist (FA). Unfortunately, many APPs lack any formal surgical training. The Association of perioperative Registered Nurses (AORN) now requires that all advanced practice providers in the perioperative environment to complete a course that complies with Registered Nurse First Assist (RNFA) standards. The purpose of this project was to evaluate knowledge acquisition of APPs participating in a surgical FA educational program. A surgical FA course was comprised of five days of didactic learning, which included lecture, small groups, skills lab, …

The Effect Of Basal Bolus Insulin Administration Vs. Sliding Scale Insulin On Glycemic Control In Patients With Type 2 Diabetes Mellitus At A Community Hospital, Meriam Signo

Doctoral Projects

Evidence of effective insulin delivery by nurses can help prevent fluctuating plasma glucose levels of Type 2 diabetes mellitus (T2DM) in the hospital setting. Information leading to better diabetes care using either basal bolus insulin administration (BBI) or sliding scale insulin (SSI) is essential for safe blood sugar values. The purpose of this project was to measure patient glycemic control after the implementation of BBI vs. SSI during a patients’ stay in the hospital. This study was a quantitative, retrospective exploratory chart review of T2DM in medical-surgical units at a Northern California community hospital. The data were collected from routine …

Identifying Perceived Barriers To Primary Health Care Access In Rural, Medically Underserved Areas, Suzanne Hewitt

Doctoral Projects

Persons living in rural areas designated as having primary care provider shortages often lack access to timely and appropriate levels of care, frequently forcing them to forego care, delay treatment, or seek care in an emergency department for non-urgent complaints. This qualitative study reviewed evidence-based research and data generated from two focus groups sessions to generate a body of distinctive knowledge of the barriers to primary healthcare access as perceived by members of this rural, medically-underserved area of northern California. The theme that was identified, through conventional qualitative content analysis, as most prevalent among subjects was the inability to schedule …

Exploring Ways To Improve Healthcare Access For The Homeless Population In Merced County, Stella Nwasoka Adesokan

Doctoral Projects

Homelessness is a societal dilemma that affects people in the United States and around the globe. Homelessness relates to poor health conditions that affect the living conditions of individuals (Institute for Urban Initiatives, 2018). Chronic and acute illnesses are rampant in this group, most of these illnesses are treatable but accessing healthcare poses a challenge for this vulnerable population. Homeless persons are often unable to access healthcare due to fear and denial of ill health, difficulty in communicating health needs, and low self-esteem (Lamb & Joels, 2014).

In the study, questionnaires were administered to 25 homeless individuals through random sampling. …

Human Papillomavirus Vaccine Program, Magdalena Ruiz

Doctoral Projects

Pediatric primary care focuses on maintaining patients’ health, preventing diseases, and assessing children’s developmental milestones. Vaccine administration and disease prevention are key components of a well-child exam for pediatric patients; however, vaccine refusal is an important complication of pediatric patient care. Of particular interest to this researcher is the HPV vaccine which was approved by the Federal Drug Administration and is currently recommended by the Centers for Disease Control and Prevention (2016) for both males and females, beginning at 11 or 12 years of age through age 26 years. The HPV vaccine protects against diseases and cancers caused by the …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Nurses’ Perception Of Discharging The Medically Complex Pediatric Patient, Stacie Camille Licon

Doctoral Projects

The purpose of this study is to query the nurses for their perceptions of the barriers and facilitators of discharging medically complex pediatric patients from a freestanding children’s hospital in central California. Using a mixed methods research design via an online survey, 90 nurses identified 3 distinct themes that act as barriers. Those barriers include: 1) knowing the plan of care, 2) time, and 3) disposition of the family. Several implications for improving the discharge process for medically complex patients and overcoming the identified barriers include strategies to improve multidisciplinary communication, implementation of a Family Learning Center, use of video …

Advanced Informatics Competencies Of Nurses At Sutter Maternity And Surgery, Jessica Liston

Doctoral Projects

Today, the profession of nursing requires the integration of many sciences and skill sets in order to care for the increasing acute and chronic illness in our patient populations. In order for nurses to safely care for patients in highly technological environments, they must integrate knowledge from Nursing Informatics (NI), to advance the profession, deliver safe high-quality patient care and effective documentation that drives improvement in patient outcomes. When nurses have an understanding of advanced NI skills, they are better equipped to become super users that train and lead teams in optimization of electronic health records (EHRs) to support them …

Identifying Predictors Of Airway Complications In Conscious Sedation Procedures, Rosemary Bray

Doctoral Projects

Problem: Conscious sedation procedures are complicated by unanticipated airway compromise and obstruction. The STOP-Bang questionnaire (University of Toronto, 2012) is a validated obstructive sleep apnea (OSA) screening questionnaire used as a pre-procedure evaluation tool to assess a patient’s risk for OSA. There are four verifiable, objective questions and four subjective questions. This study examines to what extent the STOP-Bang score question variables reliably predict airway complications during conscious sedation procedures.

Method: The method was a retrospective review of data from the electronic medical record (EMR) of patients who had conscious sedation for endoscopy procedures. The individual questions of the STOP-Bang …

Pilot Study: Program Evaluation Of Peanut Oral Immunotherapy In A Private Clinic, Kinga Olson

Doctoral Projects

The privilege of providing a therapy perceived by patients and families as “life changing” has seasoned physicians describing food oral immunotherapy (OIT) as one of “the most impactful and rewarding thing that they have done in medicine” (Wasserman, Jones, & Windom, 2018). OIT is a medical treatment that allows the immune system to become desensitized to a food to which it may otherwise be allergic. This is not a cure for food allergies but a way to decrease the incidence of anaphylaxis due to accidental ingestion. Living with food allergies can be distressing due to the daily fear of exposures. …

Promoting Self-Efficacy Among Head And Neck Cancer Patients, Lily Lam

Doctoral Projects

Current survivorship visits at the Stanford head and neck oncology program are not standardized to address ongoing post-treatment sequelae. The objectives of this study help to address whether current non-standardized visits actually help to empower patients to self-manage their chronic diagnosis of head and neck cancer by measuring their self-efficacy levels before and after their post-treatment survivorship visit.

Given the convenience sampling method, 17 patients were enrolled in this quasi-experimental pilot study. Demographic information was collected for each patient: gender, ethnicity, smoker status, and age. Head and neck cancer patients would first be surveyed before and after their follow up …

Pilot Study Of A Breastfeeding Support Training Program Designed Particularly For Infants With Common Congenital Anomalies And Defects, Gretchen Nelson Ezaki

Doctoral Projects

The American Academy of Pediatrics (American Academy of Pediatrics [AAP], 2018), the World Health Organization (World Health Organization [WHO)], 2018), and The March of Dimes (March of Dimes, 2016) recommend exclusive breastfeeding for the first six months of life. In 2014, 79% of women in the United States began breastfeeding their infants, but only 40.7% and 18.8% continued breastfeeding exclusively at three and six months respectively (Centers for Disease Control and Prevention, 2017). This doctoral project promotes breastfeeding by creating and testing simple teaching algorithms for training registered nurses to support breastfeeding, including for infants with trisomy 21, congenital heart …

The Modeling Assessment Of World Vision’S Water, Sanitation, And Hygiene Program In Southern Africa Countries, Malawi, Mozambique, And Zambia: Analyses Using Lives Saved Tool, Chulwoo Park, Armen Martirosyan, Seble Frehywot, Erin Jones, Ashley Labat, Yvonne Tam, Emmanuel Opong

Faculty Publications

Background: Since 2010, the humanitarian aid organization World Vision has implemented a community-based water, sanitation, and hygiene (WASH) program in 76 area development programs (ADPs) for a total target population of 2,831,535 in three Southern Africa countries: Malawi, Mozambique, and Zambia.

Methods: This study was conducted using the Lives Saved Tool (LiST) to analyze the isolated impact of World Vision WASH interventions on child morbidity and mortality during the four-year implementation period from 2010 to 2014. The combined effects of WASH interventions – improved water source, home water connection, improved sanitation, handwashing with soap, hygienic disposal of children’s stools – …

Perceptions Of Adult Patients Accessing Telehealth In An Urban Medical Group, Katharine Shepherd West

Doctoral Projects

Problem: Although implementation of in-patient electronic healthcare records is nearly complete in the United States, this achievement has not translated into consumer-to-business telehealth in the primary care setting. Because there are few studies that describe how and why patients select telehealth, the aim of this study was to learn about perceptions of adult patients in an urban setting when telehealth options are available. Research questions included a) How do patients select any type of appointment? b) How do patients perceive and use telehealth options? c) How and when might telehealth be useful in the future?

Methods: A qualitative study design …

Caring For The Pediatric Neurofibromatosis Type-1 Patient: Improving Nursing Knowledge Through An Innovative Educational Tool, Samantha Ingerick

Doctoral Projects

Standardized nursing education can help equip nurses with appropriate skills needed to care for certain patient populations. Pediatric neurofibromatosis type-1 (NF1) patients have unique health needs, and often seek care at institutions where no NF1 training has been provided. The purpose of this project was to explore existing nursing NF1 knowledge and knowledge perception in a pediatric oncology infusion center within a large bay area children’s hospital, a location where nurses have varied NF1 education and have recently been asked to care for this population. Malcolm Knowles’ adult learning theory was used to design an NF1 educational tool for nurses. …