Medicine and Health Sciences Commons^™

Improving Health Equity: Integrating Mental Health Services Into Mobile Health Clinics For Unhoused And Low-Income Populations In The United States, Tiffany Lynn Wong

Master's Projects and Capstones

Mental health disparities among homeless and low-income populations in the United States highlight significant challenges in access and quality of care. This literature review explores the integration of mental health services into Mobile Health Clinics (MHCs) as a promising recommendation to address these disparities. I used various search engines, extracting 10 articles published from 2013 to 2023 focused on the U.S. MHCs show its effectiveness in improving healthcare access and quality of care, covering different services like mammography, reproductive health, COVID-19 testing, and diabetes care. Building on these successful models, this paper proposes extending MHCs to include mental health screenings, …

Reducing Heart Failure Readmissions Through Standardized Daily 1:1 Education, Neil R. Carlos

Master's Projects and Capstones

Problem: In 2023, a Northern California hospital's Cardiac Procedure Unit (CPU) admitted 100 heart failure patients, with 24 readmissions primarily due to inadequate self-management education. These admissions cost over $8.4 million, highlighting the urgent need for better patient education to reduce readmissions and healthcare expenses.

Context: A quality improvement initiative was launched in the CPU that handles pre- and post-cardiac care, including for heart failure patients. The unit's focus on urgent care and other priorities resulted in insufficient patient education regarding heart failure.

Intervention: From January to June 2024, the initiative implemented daily personalized teach-back education sessions on self-management. These …

Beat The Clock: Improving First Case On-Time Starts (Fcots) In The Ambulatory Surgery Unit (Asu), Myrna M. Bernardo

Master's Projects and Capstones

Abstract

Problem: A local Bay Area hospital Ambulatory Surgery Unit (ASU) strives to maintain the first case on-time starts (FCOTS) at 90%. Optimal FCOTS compliance enhances operating room (OR) efficiency, resource utilization, and patient outcomes. Data from January 2022 to December 2023 shows that ASU’s FCOTS remains at a monthly average rate of 67%. This project focuses on closing the 23% gap by achieving 73% FCOTS compliance in the first quarter to progressively achieve the unit 90% goal or higher.

Context: The five ASU ORs handle a daily volume of 25-35 cases. An interdisciplinary team conducted a root cause analysis …

The Impact Of Adverse Childhood Experiences And Allostatic Load On Premature Birth Rates: A Literature Review, Roxane J. Scherek

Master's Projects and Capstones

This paper examines the relationship between Adverse Childhood Experiences (ACEs), allostatic load, and the likelihood of women giving birth prematurely in the United States and Canada. I searched multiple databases exploring this association, identifying nineteen articles published between 2004 and 2024. The literature highlights that racism and discrimination are a cause of chronic stress, and that this stress, and implicit bias, are both implicated in preterm birth. While ACEs scores have been found to be associated with preterm birth, the results for allostatic load are mixed. The results suggest that more attention should be paid to mitigating the stress associated …

Optimizing Fall Prevention: A Quality Improvement Initiative To Enhance Documentation And Intervention Accuracy Using The Hester Davis Scale In Medical-Surgical Units, Kiana Conn, Brooklin Hunter-Johnson, Jashan Kahlon, Adrian Paz

Master's Projects and Capstones

Falls among hospitalized patients remain a critical safety concern, particularly in medical-surgical units caring for geriatric and oncology patients. This quality improvement project aimed to evaluate and address gaps in adherence to fall prevention protocols by utilizing the Hester Davis Scale (HDS) in two medical-surgical units at a large metropolitan hospital in Southern California. The project focused on auditing current practices to identify inconsistencies in documentation and intervention implementation, emphasizing areas such as bed alarm activation, fall risk signage placement, and armband use. Weekly audits were conducted from October 3 to October 29, 2024, to establish baseline data and inform …

Improving Anesthesia Technician Workflow: Implementation Of A Standardized Checklist And Formal Handoff Communication Tool To Enhance Management Of The Pediatric Portable Anesthesia Lockers Recommendation, Megan Shayna Sosnick Msel, Rn

Master's Projects and Capstones

Objective: The surgical department of a well-known Bay Area medical center faces substantial challenges in supply management. These challenges include inconsistent stocking, disorganized storage, and an inefficient ordering process. These logistical issues impact patient care negatively, increase supply costs, and weaken team morale and communication. U.S. hospitals spend $83 billion annually on medical supplies, with $25.4 billion wasted on preventable material expenses (Balkhi et al., 2022). Aim and Methods: This quality improvement project aims to train 80% of anesthesia technicians in proper stocking procedures for portable pediatric anesthesia lockers within three months. Interventions include the implementation of a standardized …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In The Adult Oncology Population Through Improved Compliance With Oral Hygiene Protocols, Kenneth R. Brown

Master's Projects and Capstones

Objective

Oncology patients receiving chemotherapy are at risk of complications such as mucosal barrier injuries (MBI) and aspiration pneumonia, and aspiration pneumonia rates are higher than desired. Improved oral hygiene protocols and compliance in this population reduces the incidence of these complications.

Context and Background

The microsystem assessed includes six oncology units at Hospital A, a large California academic hospital. Aspiration pneumonia, commonly associated with MBI, is a life-threatening challenge that increases costs and complications in oncological treatment settings. An aspiration pneumonia task force focused on six oncology acute care units is committed to reducing the incidence of hospital acquired …

Transforming Care: Elevating Oral Hygiene Compliance To Combat Nosocomial Aspiration Pneumonia In Adult Oncology Patients, Karina Larrea

Master's Projects and Capstones

Objective Aspiration pneumonia is a preventable, yet common complication in oncology patients undergoing chemotherapy, steered by suboptimal compliance with oral hygiene protocols and elevated susceptibility due to mucosal barrier injuries. Despite its major impact on healthcare costs and morbidity, compliance with evidence-based practices remains inadequate. Aim This project aimed to decrease nosocomial aspiration pneumonia rates from 1.5% to 1.3% by enhancing oral hygiene compliance from 41% to 70% over a 12-week period. Methods Proposed interventions included implementing paired oral hygiene order sets into electronic medical records, once-per-shift cues, staggered patient education sessions, and staff education on standardized protocols. Pre-intervention data …

Implementation Of A Food Security Program To Reduce Hypertension At A Primary Care Clinic, Maribel Ballesteros

Master's Projects and Capstones

The food security program aims to reduce hypertension and food insecurity by increasing access to fresh fruits and vegetables. Although food insecurity is a growing public health issue, the food security program experienced significantly low enrollment compared to projected values. The quality improvement project was conducted in an adult medicine department in a primary care clinic in San Francisco serving the Latinx community. To address the issue of low program enrollment, a comprehensive educational food security program flyer was developed containing program information, including frequently asked questions. The flyer aimed to increase program enrollments by increasing program education. Fifty flyers …

Optimizing Peripartum Bedside Reports Through Patient-Centered Communication, Harpreet Kaur

Master's Projects and Capstones

Abstract

Background Effective patient-centered communication (PCC) during bedside shift reports (BSR) is crucial in peripartum care, where patients face physical recovery and emotional adjustment. However, communication gaps during transitions from labor and delivery (L&D) to postpartum (PP) units can lead to patient dissatisfaction and misinterpretation of care instructions. Hospital A, an urban tertiary care medical center in San Francisco, operates a peripartum mesosystem across two floors with 35 dedicated beds. Aim The project aims to increase patient satisfaction by implementing patient-centered language in bedside reports for peripartum units from 70% to 80% for a three-week period. Methods Stakeholder engagement, a …

Utilizing Pupper, A Social Robot Dog, To Increase Happiness And Improve Mood In Pediatric Patients Of A Cardiac Step-Down Unit, Angela Feng Wu

Master's Projects and Capstones

Objective The usage of social robots in pediatrics is an emerging field of study. Preliminary research shows that they are effective at improving the psychosocial well-being of pediatric patients. This quality improvement project focuses on Pupper, a newly developed quadruped social robot dog, and its ability in improving mood and happiness in pediatric patients of a cardiac step-down unit. Aim The aim of this project is to increase average mood scores of pediatric cardiac patients aged 3-25 years by 50% from their baseline of 3.75 to 5.63 on a six-point scale within a one-month time frame. Methods Before intervention and …

Implementing Donna Wright’S Competency Model For Enhancing Nursing Professional Development In Pediatric Perioperative Units, Justin C. Chu

Master's Projects and Capstones

Background Hundreds of thousands of deaths occur in hospitals annually due to preventable adverse events. As literature shows nurse competency is positively associated with improved patient outcomes, it is the mission of any healthcare organization to continually improve staff competency. Bay Area Children’s Hospital X is looking to adopt the Donna Wright Competency Model (DWCM) to change the way they approach this process, transitioning from traditional methods of manager-selected competencies to a collaborative, shared governance approach. Objectives Utilizing the DWCM, the project goal is to enhance competencies among 90 nurses in pediatric perioperative units. The ultimate goal is to create …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Assessing The Reach Of Health Access Resources In Indianapolis For Populations With Low Income, Kyler A. Casbon, Kai J. Gatting, Simran Nadig, Isabella K. Peckinpaugh, Alexandre A. Sauquet, Kourtney A. D. Byrd, Megan E. Conklin, Gicella Garcia, Mitchell L. Struewing, Omolola A. Adeoye-Olatunde

Purdue Journal of Service-Learning and International Engagement

Two public health crises that the United States are contending with are diabetes and the prevalence of opioid overdoses, both of which have a significant impact on communities nationwide. Inequities in social conditions contribute to health disparities amidst these diabetes and opioid overdose public health crises nationally and locally. To address these health inequities in Indianapolis, Indiana, the the Purdue University Center for Health Excellence, Quality and Innovation (CHEQI) shaped relationships through their CHAMP (Community Health Access Model Partnerships) services with local food pantries and homeless shelters, providing Indianapolis residents pre-diabetes screening and resources and convenient access to and education …

Jovial Family Farm Facilitates Intergenerational Learning Opportunities Through Urban Farming, Maera Williams

Purdue Journal of Service-Learning and International Engagement

Maera Williams is a sophomore in Environmental and Ecological Engineering at Purdue University. She joined the Engineering Projects in Community Service (EPICS) Urban Farming team as a freshman and now serves as project manager of ten undergraduate students collaborating with Jovial Family Farm to design and develop three indoor hydroponics systems for a laboratory space on their property in Broad Ripple, IN. Jovial Family Farm is a nonprofit organization founded by Drs. Bobbie and Brian Jellison with the mission to provide senior citizens, their families, and their communities with meaningful engagement opportunities on an intergenerational scale through urban agricultural activities. …

Comparison Of Efficacy Between Thai Herbal Anti-Hemorrhoid Formula And Micronized Purified Flavonoid Fraction In Patients With Internal Hemorrhoids, Darunee Rattanawongsamathakul, Varut Lohsiriwat, Suksalin Booranasubkajorn, Angkana Apichartvorakit, Pravit Akarasereenont

Journal of Health Research

Background: Hemorrhoids are a common anorectal condition. In Thai traditional medicine, the Bantaoridsidwangthawan formula (BRF) has been used to treat hemorrhoids. We aimed to evaluate the clinical efficacy and satisfaction of BRF versus Micronized purified flavonoid fraction (MPFF) in patients with internal hemorrhoids grades 1 and 2.

Methods: This was a single-blind, randomized control noninferiority trial. Twenty-seven participants were randomly assigned to BRF (n=13) or MPFF (n=14). The BRF group received 5 pills 3 times daily for 14 days. The MPFF group received 2 tablets 3 times daily for 4 days, and then 2 tablets 2 times daily …

Biomarkers Of Formaldehyde Exposure For Health Surveillance, Songkran Deeruen, Vorakamol Boonyayothin, Urai Chaisri, Songsak Petmitr, Aronrag Cooper Meeyai, Manee Chanama, Natkamol Chansatitporn, Wantanee Phanprasit

Journal of Health Research

Background: This study aimed to identify suitable biomarkers of formaldehyde exposure to conduct health surveillance among embalmers. Micronucleus frequency, DNA damage, and genetic polymorphisms were studied.

Methods: Ninety-eight staff in 13 hospitals were recruited and categorized into high or low formaldehyde exposure groups (n=49 for each group). For each participant, personal air sampling was taken and analyzed using the NIOSH method 2016. On the same day of air sampling, participants’ buccal tissue was collected and analyzed for micronucleus frequency by staining, DNA damage using the Comet assay, and polymorphism of Glutathione S-Transferase Pi 1 (GSTP1) by polymerase chain …

The Abusive Effects Of Trauma On Leadership Styles And Performance, Robert Kraft

Doctor of Ministry Major Applied Project

This Doctor of Ministry (DMin) Major Applied Project (MAP) investigates the relationship between toxic leadership in the military and trauma, particular how trauma can have negative, abusive effects on leadership style and performance. Most research in this area addresses trauma in postvention. This MAP addresses trauma’s potential effect on leadership style and explores the use of a pre-emptive, preventative training. Leadership theory is explored as well as trauma in the form of mental disorders, such as PTSD and narcissism. The author’s experience as an ordained pastor of The Lutheran Church—Missouri Synod, serving as an Army Chaplain, revealed the value of …

Nursing Home Staff Perspectives Of The Benefits And Challenges Of Providing Dementia Care, Carin M. Wong, Dominique H. Como, Cara Lekovitch, Felicia Chew, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

OBJECTIVES: To capture nursing home staff perspectives on the benefits and challenges related to caring for residents living with Alzheimer disease and other related dementias. These perspectives will inform the initial development of strategies to help with staff retention.

DESIGN: A secondary qualitative analysis of semistructured interviews conducted with nursing home staff, which was embedded within a pragmatic clinical trial.

SETTING AND PARTICIPANTS: Purposive sampling was used to capture perspectives of staff spanning across job roles from 23 nursing homes.

METHODS: During the parent study primary analysis, staff experiences providing dementia care were consistently described. In response, this study completed …

Small Molecule With Big Impact: Metarrestin Targets The Perinucleolar Compartment In Cancer Metastasis, Vivek Kashyap, Bhuvnesh Sharma, Divya Pandey, Ajay K. Singh, Godwin Peasah-Darkwah, Bhupesh Singh, Kuldeep K. Roy, Murali Yallapu, Subhash Chauhan

School of Medicine Publications

Metarrestin (ML246) is a first-in-class pyrrole-pyrimidine-derived small molecule that selectively targets the perinucleolar compartment (PNC). PNC is a distinct subnuclear structure predominantly found in solid tumor cells. The occurrence of PNC demonstrates a positive correlation with malignancy, serving as an indicator of tumor aggressiveness, progression, and metastasis. Various promising preclinical results have led to the clinical translation of metarrestin into a first-in-human trial. This review aims to summarize (i) the current understanding of the structure and function of PNC and its role in cancer progression and metastasis, (ii) key findings from studies examining the effect of metarrestin on various cancers …

Medical School Watercooler Newsletter - December 12, 2024, Lindsay Hughes

Watercooler Newsletter

This is the Thursday, December 12, 2024 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

Contents include:

• Mbaka first in area to implant breathing device in patient with quadriplegia
• Faculty, medical student publish article on neonatal birth fractures in academic journal
• Doc Rock band spotlight: The Grey Scrubs
• Neonatologist Ikeri selected for national award
• Medical student presents research on peer-led academic support at national conference
• Help fulfill Ronald McDonald House wish list
• Cardiologist Manoharan joins internal medicine faculty
• USA Health expands neurointensive care with addition of Chalela

​​Living With Parkinson’S During Covid-19: A Survey Of Parkinson’S Patients During Covid-19​, Sia Shaila Pilgaonkar

Undergraduate Theses

The COVID-19 pandemic has significantly impacted individuals with Parkinson's disease (PD), raising concerns about exacerbation of symptoms and vulnerability of the patients. This project first reviews existing literature on the interconnections between COVID-19 and PD, focusing on the physiological, psychological, and treatment-related challenges faced by patients. Then it analyzes survey data examining increased severity of COVID-19 in individuals with PD, alongside the literature researching potential mechanisms linking the two, such as inflammation and neurodegeneration. The survey’s key areas of focus included symptom management, treatment satisfaction, the impact of PD on daily living, and the impact of COVID-19 on motor and …

A Conjugate Of An Egfr-Binding Peptide And Doxorubicin Shows Selective Toxicity To Triple-Negative Breast Cancer Cells, Phi-Phung Than, Shih-Jing Yao, Emad Althagafi, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Selective targeting of cancer cells via overexpressed cell-surface receptors is a promising strategy to enhance chemotherapy efficacy and minimize off-target side effects. In this study, we designed peptide 31 (YHWYGYTPERVI) to target the overexpressed epidermal growth factor receptor (EGFR) in triple-negative breast cancer (TNBC) cells. Peptide 31 is internalized by TNBC cells through EGFR-mediated endocytosis and shares sequence and structural similarities with human EGF (hEGF), a natural EGFR ligand. Unlike hEGF, peptide 31 does not induce cell migration in TNBC cells. A novel conjugate of peptide 31 with doxorubicin (Dox) retains selectivity for TNBC cells and exhibits significant toxicity comparable …

12.02.2024 Orsp Connect, Liz Williamson

ORED Newsletter

Email Address Matters

All of Us Researcher Symposium

Welcome Anya Goldman

Hypoxia-Inducible Factor 3Α1'S Role In Promoting Iron Loading, Tumorigenesis, And Metastasis In Colorectal Cancer, Luke B. Villareal

Biomedical Sciences ETDs

The interplay between hypoxia and iron metabolism drives colorectal cancer (CRC) progression. This dissertation investigates hypoxia-inducible factor 3α1 (HIF-3α1), a protein linked to poor CRC outcomes, focusing on its roles in metastasis, epithelial-to-mesenchymal transition (EMT), and iron loading via transferrin receptor (TFRC). HIF-3α1 promotes CRC cell migration by upregulating zinc finger E-box binding homeobox 2 (ZEB2) and suppressing N-myc downstream-regulated gene 1 (NDRG1), while TFRC-mediated iron accumulation supports tumor growth and survival. Iron chelation reduced EMT markers, migration, and tumor growth, highlighting iron's critical role. Additionally, HIF-3α1-induced TFRC expression altered nucleotide synthesis enzymes carbamoyl-phosphate synthetase-aspartate transcarbamoylase-dihydroorotase (CAD) and phosphoribosyl pyrophosphate …

Port-Wine Stain Treatment With 577-Nm Laser: Treatment Outcomes Of Superficial Versus Deep Lesions, Yulia Siskawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Port-wine stains (PWS), or capillary malformations (CM), are congenital vascular anomalies characterized by gradual enlargement of the superficial cutaneous vascular plexus, leading to low-flow malformations in the skin. Laser therapy remains the preferred treatment for PWS. The 577-nm vascular laser system is particularly suited for treating cutaneous vascular disorders. This study evaluates the efficacy of the 577-nm vascular laser for both superficial and deep PWS lesions.

Case Illustration: Three adult patients, all aged over 17 years old, were treated with the 577-nm laser. In the first case with deeper PWS, four treatment sessions resulted in flattening of hypertrophic areas, …

Comparative Efficacy, Safety, And Oncological Outcomes Of Percutaneous Thermal And Chemical Ablation Modalities For Recurrent Metastatic Cervical Lymphadenopathy From Thyroid Cancer, Eman A. Toraih, Siva Paladugu, Rami M. Elshazli, Mohammad M. Hussein, Hassan Malik, Humza Pirzadah, Ahmed Abdelmaksoud, Salem I. Noureldine, Emad Kandil

School of Medicine Faculty Publications

Background: Thermal and chemical ablation techniques may consolidate recurrent metastatic cervical lymph nodes as alternatives to repeat neck dissection in thyroid cancer patients. This meta-analysis aims to compare the efficacy and safety across modalities. Methods: Four databases were searched for studies on radiofrequency (RFA), microwave (MWA), laser (LA), and ethanol ablation (EA) treating metastatic cervical nodes from thyroid cancer. The outcomes analyzed included treatment response, oncologic control, and complications. Random effects meta-analytical pooling was conducted. Results: There were 25 studies (n = 1061 nodes) examining the four ablation methods. Patients showed comparable baseline characteristics and initial lymph node sizes ranging …

The 2024 Nobel Prize In Physiology Or Medicine: Microrna Takes Center Stage, George A. Calin, Florent Hubé, Michael R. Ladomery, Nicholas Delihas, Manuela Ferracin, Laura Poliseno, Luca Agnelli, Suresh K. Alahari, Ai-Ming Yu, Xiao-Bo Zhong

School of Medicine Faculty Publications

The Non-coding Journal Editorial Board Members would like to congratulate Victor Ambros and Gary Ruvkun, who were jointly awarded the 2024 Nobel Prize in Physiology or Medicine for their groundbreaking discovery of microRNAs and the role of microRNAs in post-transcriptional gene regulation, uncovering a previously unknown layer of gene control in eukaryotes [...].

An Integrative Review Of Trauma Informed Care With Pediatrics To Minimize Psychological Sequelae Post Discharge, Amber Lee, Courtney Heinzelman

Master's Projects

Each year, a significant number of children sustain injuries requiring hospitalization, and while many recover physically, some face long-term psychological challenges such as post-traumatic stress, anxiety, and depression. This integrative review focuses on adolescents aged 13–18 who have experienced accidental trauma, exploring how trauma-informed care (TIC) in nursing compares to traditional approaches in reducing psychological impacts after discharge. Research suggests that many young patients report mental health symptoms for months following traumatic events. Trauma-informed care prioritizes principles such as safety, trust, peer support, and empowerment, aiming to reduce emotional distress and promote recovery. This review examines the application of these …