Medicine and Health Sciences Commons^™

Follow-Up Among Homeless Patients At San Francisco General Hospital: Examining The Social Determinants Of Health, Robert Gnat

Doctoral Projects

The San Francisco General Hospital emergency department has a high occurrence of homeless patients that are lost to follow-up after discharge. This Doctor of Nursing Practice project conducted a survey to evaluate the social determinants of health among this population and how they influence the participant’s ability to follow-up. This is the first phase of a three-phase project involving assessment and evaluation. The second and third phases of this project will center on intervention and re-evaluation after intervention. The survey was administered to eligible participants who presented to the emergency department at San Francisco General Hospital. Fifty participants were surveyed …

The Association Of Modified Early Warning Score On Patient Outcomes In Medical-Surgical Units In An Academic Medical Center, Gerundio Ursolino Iii, Msn, Mba, Ccrn-K

Doctor of Nursing Practice Projects

Background: A nationwide problem that has been regularly overlooked is poor recognition of deteriorating patients which can lead to increased severity of illness. One way to avoid adverse events is early detection of clinical deterioration using vital signs via Modified Early Warning Score (MEWS). However, the majority of the hospitals across the United States are not utilizing this. MEWS implementation can minimize adverse events by early recognition, which will lead to early intervention and improved patients’ outcomes.

Objective: The aim of this quasi-experimental study was to determine if MEWS implementation will reduce the number of adverse outcomes.

Methodology: …

Development And Validation Of The Parental Smartphone Use Management Scale (Psums): Parents’ Perceived Self-Efficacy With Adolescents With Attention Deficit Hyperactivity Disorder, Yi-Ping Hsieh, Cheng-Fang Yen, Wen-Jiun Chou

Social Work Faculty Publications

The psychometric properties of the Parental Smartphone Use Management Scale (PSUMS) and its prospective relationships with symptoms of smartphone addiction and attention deficit hyperactivity disorder (ADHD) were studies in a sample of parents of adolescents with ADHD. This is a scale to measure parents’ perceived self-efficacy on managing their children’s smartphone use. Construct validity (exploratory factor analysis and confirmatory factor analysis), criterion-related validity (known-group validity and concurrent validity), and reliability (Cronbach’s alpha) were performed for data analyses. The results showed that the PSUMS had good factorials validity and high reliabilities, with Cronbach’s alphas ranging between 0.93 and 0.95. The 17-item …

The Impact Of The Aca Cost-Sharing Elimination Provision On The Utilization Of Breast, Cervical, And Colorectal Cancer Screening Services Among Insured Individuals In The United States, Sara Salah Atallah

Dissertations and Theses (Open Access)

Preventive cancer screenings are essential to early detect cancer and subsequently save lives. However, out-of-pocket expenditures for cancer screening services deter individuals from obtaining them. In an effort to improve the utilization of cancer screening, the Affordable Care Act (ACA) implemented a cost-sharing elimination provision that removes all forms of cost sharing including copayments, co-insurance and deductibles from certain preventive care services that are recommended by widely known scientific figures such as the United States Preventive Services Task Force (USPSTF). This study evaluated the impact of the ACA cost-sharing elimination provision for preventive care services from 2008 through 2016 using …

The Implications Of Ace Science: A Call To Respond, Valerie Norcross

The Diana McDonald Writer's Challenge

In “The Implications of ACE Science: A Call to Respond,” Valerie Norcross employs a professional format for writing in the field of psychology. Her essay cites studies linking Adverse Childhood Experiences (ACEs) with higher mortality rates due to a range of causes. Norcross explains some of the scientific theories for why childhood traumas contribute to shorter life expectancies. She describes efforts to screen children for ACEs and interventions for diminishing the long-term detrimental health effects of ACEs.

Gut Feeling: Good Food, Good Mood, Asia Battle

The Diana McDonald Writer's Challenge

In “Gut Feeling: Good Food, Good Mood,” Asia Battle describes the emerging field of nutritional psychiatry. Her essay explains why psychotropic medications can be unreliable and, over time, even counter-productive for treating ADHD, autism, bipolar disorder, and other disorders with which children are being increasingly diagnosed. Battle explains some of the science linking proper nutrition with relief from mental/emotional distress and offers suggestions for transitioning from poor diets (including the treats that we may use to placate children) to diets that promote physical and emotional well-being.

Initial Results Of A Prospective Study Of Adjuvant Pancreatic Stereotactic Body Radiation Therapy For Close Or Positive Margins, Mark E. Bernard, Philip A. Sutera, Nicholas A. Iarrobino, Kimmen Quan, Steven A. Burton, Nathan Bahary, Melissa Hogg, Amer Zureikat, Dwight E. Heron

Radiation Medicine Faculty Publications

Purpose: Patients with close or positive margins after surgery for pancreatic carcinoma are at a high risk for recurrence. Stereotactic body radiation therapy (SBRT) allows for safe dose escalation with great conformity and short duration of treatment. Herein, we report the initial results of a prospective observational study that evaluated the efficacy and safety of this treatment option.

Methods and Materials: Patients eligible for the study had pathologically proven T1-4N0-1M0 pancreatic adenocarcinoma with a positive margin (≤ 1 mm) or a close margin defined as < 2.5 mm. Patients were treated with either neoadjuvant or adjuvant chemotherapy, if eligible for systemic therapy. All patients received 36 Gy in 3 fractions to the close or positive margin site.

Results: From February 2013 to January 2018, 50 patients were enrolled with 49 patients treated …

Exploring Turnover Among Nurse Managers, Directors, And Executives In Acute Care Hospitals, Deborah Hughes Warden

Theses and Dissertations

Background: The strength and quality of the nursing leader workforce is associated with staff nurse retention and patient outcomes. While leadership turnover is not always negative, there is still uncertainty, loss of program continuity, power shifts within an organization, and significant expense for the organization in recruiting and integrating a new leader.

Purpose: The purpose of this study is to explore intent to leave and turnover experiences of acute care nurse managers, directors, and executives.

Methods: For this nationwide survey, recruitment was done via snowball sampling through state hospital associations and professional organizations across the US with a resulting sample …

Pediatric Patients With Diabetes Transition To Adult Care, Sara Jennings

Doctoral Projects

The purpose of this study was to identify the optimal age to target transition to adult care education for adolescent and young adults (AYA) with Type 1 and Type 2 Diabetes Mellitus (DM) as they transition from pediatric endocrinology providers to adult DM providers. A secondary purpose of this study was to identify if there was a relationship between attendance rate, age, gender, years diagnosed with DM, ethnicity, insurance type, Type of DM, and current county of residence with control of diabetes, measured by glycosylated hemoglobin (HgbA1c). A quantitative study through chart audits was conducted at Valley Children’s Healthcare, VCH, …

Static Shoulder Elevation With Or Without Limited Range Of Arm Motion, Kayla Ericson

Graduate Theses & Non-Theses

Purpose: The purpose of this study was to investigate the effect of two similar low force, upper arm holding tasks on shoulder muscle fatigue. One task involves static holding, while the comparison task involves limited up and down motions, dynamic rolling. Both tasks require the shoulder muscles to hold the combined weight of the arm, hand, and a roller brush in a manner similar to that of a painter standing on a portable ladder painting a wall.

Methods: Twenty volunteer participants from undergraduate classes performed two similar tasks. One was holding their dominant arm above their shoulder while holding a …

Effect Of Repetition On Time To Don And Adjust A Fall Protection Harness, Zachary Bunney

Graduate Theses & Non-Theses

A major concern in the field of occupational safety and health is the fatalities resulting from falling from heights. In the construction industry, a common approach for protecting workers is the use of a fall protection harness connected to a secure anchor. To be effective, harnesses must be fitted and adjusted to the individual. This requires training on adjusting the straps of a harness, and the training must include practice to ensure the worker has the skills to make a secure fit. It would be useful for those who conduct training on harness fitting to know if trainees would benefit …

Effects Of Adventure Therapy Versus Support Groups On Emotional Stability For Veterans With Ptsd Transitioning Into Civilian Life, Samantha Routzahn

Spring Showcase for Research and Creative Inquiry

My research question asks if veterans with PTSD transitioning to civilian life who participate in up to one week of adventure therapy versus support groups improve emotional stability throughout the community reintegration process. Adventure therapy is a therapeutic initiative that combines outdoor adventure activities (e.g., hiking, canoeing, etc.) with facilitated therapeutic group process sessions that engage participants cognitively, effectively, and behaviorally. PTSD is a mental health condition that many veterans may experience after service. These symptoms can last for an extended period and may include flashbacks, severe anxiety, and uncontrollable thoughts about the event. Due to the military stigma against …

Effects Of Horticultural Therapy In Long Term Care Facilities On Behavioral And Psychological Symptoms Of Dementia, Morgan Scearce

Spring Showcase for Research and Creative Inquiry

My project outlines how horticultural therapy could be used as an intervention to help with the behavioral and psychological symptoms of dementia. I have created a model that can be viewed on my poster outlining the process of how to conduct a horticultural therapy intervention properly and the positive effects that would come from the intervention

Effectiveness Of Ted Stockings On Circulation And Blood Clotting, Ashley Webb, Karlie Walter, Jessica Overby, Ashlyn Hall, Meghan Griffin

Spring Showcase for Research and Creative Inquiry

Circulatory issues can stem from many disease that cause blood clots specifically in the legs, adding compression is known to help reduce blood clotting. The goal of this research project is to better understand the purpose and effectiveness of TED stocking on circulation and blood clotting and whether it is still an effective practice. The outcome of this research project is to improve our practice through the use of TED stockings for circulation and blood clotting.

Pressure Ulcers, Kelly Jeter, Courtney Frazier, Jimmy Mcdonell

Spring Showcase for Research and Creative Inquiry

During this research project, we are investigating if repositioning an immobile patient every two hours would reduce the risk of pressure ulcers forming. Pressure ulcers are caused by increased pressure or friction on bony prominences and are most likely found on immobile patients. Pressure ulcers are a major infection risk for the patient and a huge cost factor for the hospital. When the patient is immobile it becomes the nurses job to identify the risk of pressure ulcers and help prevent them from occurring. With constant repositioning every two hours, these factors could be reduced or stopped all together.

Evaluation Of Safety Related To Current Patient Mobility Practices, Karissa Bright, Logan Callahan, Sarah Saunders

Spring Showcase for Research and Creative Inquiry

A major practice that may be overlooked in the nursing field is how to move patients. Since nurses care for a diverse patient group, some patients may have limited to no mobility. In these cases, the nursing team must decide how to move the patient to provide care while still maintaining a safe environment. The purpose of this project is to evaluate current evidence on the safest ways to move and ambulate patients, while still maintaining the effectiveness that must be present in the medical environment. Hopefully, through this research, effective and safe ambulating practices can be determined.

An Evidence Based Protocol For The User Of Mindfulness For Young Adults With Eating Disorders, Emily Fischer, Scott Simmons

Spring Showcase for Research and Creative Inquiry

The student researchers used evidence based literature as well as a professional opinion from a practicing CTRS to summarize how to run a successful mindfulness program for young adults with eating disorders.

Screening Pediatric Patients For Readmission Risk, Sarah Bradshaw, Blair Buenning

Presentations

Podium Presentation of HARRPS Research Project and Findings

Observation And Self-Report Of Fun And Social Engagement Of Nursing Home Residents During Bingocize®, Lauren Rene Stevens

Masters Theses & Specialist Projects

Individuals in certified nursing facilities (CNF) often experience social isolation and have limited opportunities to exercise. Bingocize®, an evidence-based healthpromotion program, is a combination of exercise and Bingo and provides opportunities for CNF resident interaction. Limited tools are available to quantify social engagement displayed by nursing home residents. Research suggests that intergenerational programming can positively affect social engagement. The present pilot study focused on the implementation of the Fun and Social Engagement (FUSE) evaluation to measure social engagement displayed by nursing home residents during Bingocize® sessions. The FUSE combined observation and self-report measures to yield a total social engagement score. …

Factors Related To Preventive Behaviors Among Parent Caregivers Of Children Under Five Years With Acute Respiratory Tract Infection In Myanmar, Sandi Thaw, Sermsri Santati, Renu Pookboonmee

Makara Journal of Health Research

Background: Acute respiratory tract infection (ARI) is the second-leading cause of death worldwide among children, especially among those aged <5 years. Thus, it is imperative to understand parent caregivers’ perception of ARI and their preventive behaviors. Methods: This descriptive correlation study included 116 parent caregivers at an out-patient department of a 550-bedded Children Hospital, in Mandalay, Myanmar. The correlation between preventive behaviors and parent caregivers’ perception on ARI was measured using Becker’s Health Belief Model-based questionnaires. Descriptive statistics and spearmen’s rank-order collection test were used for data analysis. Results: Our results revealed that parent caregivers’ perception was at a moderate level, and preventive behaviors among parent caregivers were at a poor level during wellness …

Multilevel Sleep Surgery Including The Palate In Nonsyndromic, Neurologically Intact Children With Obstructive Sleep Apnea, Jason E. Cohn, George E. Relyea, Srihari Daggumati, Brian J. Mckinnon

Otolaryngology (ENT) Resident Research

OBJECTIVE:

To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population.

STUDY DESIGN:

A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017.

SETTING:

A tertiary care, university children's hospital.

SUBJECTS AND METHODS:

Unpaired Student t test was used to compare average pre- and postsurgical apnea-hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre- and postsurgical AHI and OSN …

A Clinician's Guide To Next Generation Imaging In Patients With Advanced Prostate Cancer (Radar Iii)., E. David Crawford, Phillip J. Koo, Neal Shore, Susan F. Slovin, Raoul S. Concepcion, Stephen J. Freedland, Leonard G. Gomella, Lawrence Karsh, Thomas E. Keane, Paul Maroni, David Penson, Daniel P. Petrylak, Ashley Ross, Vlad Mouraviev, Robert E. Reiter, Chaitanya Divgi, Evan Y. Yu

Department of Urology Faculty Papers

PURPOSE: The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration naïve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.

MATERIALS AND METHODS: The RADAR (Radiographic Assessments for Detection of Advanced …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

“Uno Logra Olvidar La Tortura”: Impactos De Las Dictaduras Militares Y Conversaciones Sobre Las Secuelas De La Tortura En El Instituto De Terapia E Investigación, Em Rosner

Independent Study Project (ISP) Collection

Investigué el impacto real de las dictaduras militares, y específicamente cómo las experiencias de tortura continuan marcando las vidas de los sobrevivientes y su habilidad de procesar los eventos de sus propias vidas, compartir sus experiencias con otras personas y hacer conexiones interpersonales. Mis preguntas primarias eran, ¿Cómo la tortura ha marcado la vida a largo plazo de las personas que la sufrieron? ¿Cómo impactan las experiencias de represión y tortura en las formas en que se construyen relaciones sociales y proyectos de vida? Para investigar este tema, entrevisté a personas que han tenido experiencias de tortura o que han …

El Rol De Los Agentes Sanitarios Para Mejorar El Acceso A La Salud Sexual Y Reproductiva Para Mujeres En San Carlos, Mendoza. / The Role Of Agentes Sanitarios In Improving Access To Sexual And Reproductive Health For Women In San Carlos, Mendoza., Laura Hult

Independent Study Project (ISP) Collection

Introducción: Es evidente que Argentina tiene un enfoque que atiende a la salud sexual y reproductiva, dado que tiene cobertura universal y la ley de Programa Nacional de Salud Sexual y Procreación Responsable que establece un estándar de cuidado para toda la población. Sin embargo, cobertura universal no implica acceso universal, el cual que está determinado por el transporte, el idioma y la cantidad de recursos de la región. En lugares como San Carlos, Mendoza, donde no hay transporte regular y hay pocos recursos, existe inequidad en la salud, lo que puede aumentar las tasas de embarazos no intencionales y …

Los Microcosmos De La Interculturalidad? Una Mirada Al Cómo Los Trabajadores De La Salud Biomédica De Orígen Indígena Relacionan Con Los Modelos De Salud Tradicional Y Occidental, Taylor Lord

Independent Study Project (ISP) Collection

Research Question: How does a biomedical health professional with indigenous roots in Chile relate the biomedical model of healthcare with the alternative indigenous model in their practice?

Objectives: The primary objective of this study was to understand how and if a biomedical health professional with indigenous roots relates and integrates two models of healthcare in their daily practice. A Secondary objective was analyzing if integration affects philosophy of care in relation to patients in critical conditions. In sum, it looked to study biomedical health professionals with indigenous roots as potential microcosms of interculturality that can demonstrate the benefits of a …

Internamente Solo: Escuchando Y Resistiendo La Soledad De Adultos Mayores En La Araucanía, Chile / Internally Alone: Hearing And Resisting The Loneliness Of Seniors In La Araucanía, Chile, Grace Ellrodt

Independent Study Project (ISP) Collection

Research Question: Which current patterns drive or diminish loneliness among seniors of the Region of the Araucanía in the city of Temuco and surrounding rural communes?

Objectives: Understand and interpret the roots and the antidotes of the loneliness phenomenon experienced by seniors in Temuco and surrounding communes in the present moment.

Identify and analyze the drivers of pathological elder loneliness in structural, intermediary, and proximal factors.

Highlight the perspectives and narratives of seniors, community leaders, and health resources with respect to strategies to reduce the crisis.

Background: Currently, the population of seniors has risen and will continue to rise in …

Continuing Education In Motivational Interviewing For Addiction Counselors: Reducing The Research‐To‐Practice Gap, Diana M. Doumas, Raissa M. Miller, Susan Esp

Counselor Education Faculty Publications and Presentations

The researchers evaluated the effectiveness of continuing education training in Motivational Interviewing (MI) for addiction counselors. Participants reported a significant increase in counseling self-efficacy and 86.8% reported increasing MI use in their practice. Only 3.9%, however, participated in post-training consultation.

Environmental Health Sciences In A Translational Research Framework: More Than Benches And Bedsides, Joel D. Kaufman, Cynthia L. Curl

Public and Population Health Faculty Publications and Presentations

Background: Environmental health scientists may find it challenging to fit the structure of the questions addressed in their discipline into the prevailing paradigm for translational research.

Objective: We aim to frame the translational science paradigm to address the stages of scientific discovery, knowledge acquisition, policy development, and evaluation in a manner relevant to the environmental health sciences. Our intention is to characterize differences between environmental health sciences and clinical medicine, and to orient this effort towards public health goals.

Discussion: Translational research is usually understood to have evolved from the bench-to-bedside framework by which basic science transitions to clinical treatment. …

Hábitos Sobre El Autocuidado En Salud Bucodental En La Ciudad Autónoma De Buenos Aires (Caba): Estudio De Caso En Los Alumnos De Una Escuela Primaria Pública En Caballito / Habits About Self-Care In Oral Health In The Autonomous City Of Buenos Aires (Caba): Case Study Of Students In A Public Elementary School In Caballito, Franklin Zhang

Independent Study Project (ISP) Collection

Información contextual: Las enfermedades bucodentales son unas de las enfermedades no transmisibles (ENT) y una de las cargas más grandes del mundo. Según la Organización Mundial de la Salud, entre el 60% y 90% de los escolares de todo el mundo tienen caries dentales, siendo una enfermedad extremadamente prevalente en el nivel primario. Además de visitas al odontólogo para chequeos de rutina, es importante prevenir esta la caries dental con una integración entre salud y educación y desarrollar hábitos saludables. El objetivo del siguiente trabajo es explorar los conocimientos sobre el autocuidado de la salud bucodental en los alumnos de …