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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Dorothy Pechman Rice Center for Health Economics

Mission

The mission of the Dorothy Pechman Rice Center for Health Economics is to provide training and mentoring to health economics professionals, conduct research, and disseminate health economics information to professional and lay audiences.

About the Center

Dorothy Pechman Rice is a medical economist and health statistician of international repute. For more than 40 years she has played a prominent role in developing the theory and methods of research about the economics of health, the costs of illness, and the analysis of the economic outcomes of health programs. She was one of the first researchers to apply the human capital approach to health care analysis, and an entire literature now exists on measuring the value of lost productivity.

Her life's work has focused on examining the health of populations, and in particular the use, delivery, and cost of health care services; health status of the population; cost of illness; aging; chronic illness; and health behaviors.

The Dorothy Pechman Rice Center for Health Economics was established in May 2000. The Center honors the values that Professor Rice has championed throughout her career: generosity in sharing time and knowledge, thoughtful analysis of health economics issues, and commitment to public service.

CHE Web Site

http://nurseweb.ucsf.edu/iha/dprice.htm

Contact Information

Dorothy Pechman Rice Center for Health Economics
Institute for Health and Aging
UCSF School of Nursing, Box 0646
3333 California St., #340
San Francisco, CA  94118

Phone:  415-502-5200      Fax:  415-476-3915
Email:  mariechristine.yue@ucsf.edu



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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Center for the Health Professions

Key Staff
Mission

The mission of the Center for the Health Professions (CHP) is to assist health care professionals, health professions schools, care delivery organizations and public policy makers respond to the challenges of educating and managing a health care workforce capable of improving the health and well being of people and their communities.

CHP Web Site

http://futurehealth.ucsf.edu

Funding

(Varies by project--see web site for details.)

Selected Publications
Personnel

See web site staff page for a list.

Contact Information

Center for the Health Professions
3333 California Street, #410
San Francisco, CA  94118

Phone:  (415) 476-8181         Fax:  (415) 476-4113



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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Center for California Health Workforce Studies

Key Staff
Overview

The Center for California Health Workforce Studies (CCHWS) was created in 1997 and is funded by a cooperative agreement with the National Center for Health Workforce Information and Analysis within the US Health Resources and Services Administration's Bureau of Health Professions.

The CCHWS builds on the extensive health workforce research and policy analysis experience of faculty and staff at the University of California, San Francisco and the UCSF Primary Care Research Center. The CCHWS brings together a multi-disciplinary team of experienced investigators to work with the Bureau of Health Professions and state agencies, particularly the Office of Statewide Health Planning and Development, to examine critical issues in the distribution, diversity, supply and competence of health professionals in California and the effects of federal and state policies on these concerns.

CCHWS is evaluating five professional areas: Medicine, Nursing, Dentistry, Allied Health, and Public Health.

Web Site

http://futurehealth.ucsf.edu/cchws.html

Funding

National Center for Health Workforce Information and Analysis,
Bureau of Health Professions, US Health Resources and Services Administration.

Selected Publications

Bindman A, Huen W, Vranizan K, Grumbach K, Streett L. (2002)  Physician Participation in Medi-Cal, 1996 - 1998. Center for California Health Workforce Studies and Primary Care Research Center, University of California, San Francisco.

Bindman AB, Yoon J, Grumbach K, Streett L. (2003)  Physician Participation in Medi-Cal, 2001. Oakland CA: Medi-Cal Policy Institute.

Coffman J, Rosenoff E, Grumbach K. (2002)  Improving recruitment and retention of primary care practitioners in rural California. Berkeley CA: California Program on Access to Care, California Policy Research Center.

Grumbach K. (2002)  Specialists, technology, and newborns - Too much of a good thing. New England Journal of Medicine, 346: 1574-1575.

Grumbach K. (2002)  The Ramifications Of Specialty-Dominated Medicine. Health Affairs, 21 (1).

Grumbach K. (2002)  Fighting hand to hand over physician workforce policy: The invisible hand of the market meets the heavy hand of government regulation. Health Affairs, 21(5): 13-27

Grumbach, K. and Bodenheimer T. (2002)  A primary care home for Americans. Putting the house in order. Journal of the American Medical Association, 288(7): 889-893.

Kevin Grumbach K, Dower C, Mutha S, Yoon J, Huen W, Keane D, Rittenhouse DR, Bindman AB. (2002) California Physicians 2002: Practice and Perceptions. San Francisco, CA: California Workforce Initiative at the UCSF Center for the Health Professions. December 2002.

McMurray JE, Angus G, Cohen M, Gavel P, Harding J, Horvath J, Paice E, Schmittdiel J, Grumbach K. (2002) Women in medicine: A four nation comparison. Journal of the American Medical Women's Association, 57 (4).

Coffman J, Spetz J, Seago JA. (2002) Minimum Nurse-to-Patient Ratios in Acute Care Hospitals. Health Affairs, 21 (5): 53-64.

Seago JA. (2002) The California Experiment: Minimum Nurse to Patient Ratios: Are there Alternatives? Journal of Nursing Administration, 32(1): 48-58.

Seago JA, Ash M. (2002) RN unions and patient outcomes. Journal of Nursing Administration, 32 (3): 143-51.

Seago JA, Spetz J. (2002) Registered Nurse Pre-Licensure Education in California. Nursing Economics, 20 (3): 113-117.

Seago JA, Spetz J. (2003) Admission Policies and Attrition Rates in California Community College Nursing Programs: A Report to Senator Charles Poochigian and the California Postsecondary Education Commission." Sacramento CA: California Postsecondary Education Commission and the University of California Policy Research Center.

Seago JA, Spetz J, Coffman J, Rosenoff E, & O'Neil E. 2003. Minimum Nurse to Patient Ratios: The California Workforce Initiative Survey. Nursing Economics, 21(2), 65-70.

Spetz J. (2002) The Value of Additional Education in a Licensed Profession: The Choice of Associate or Baccalaureate Degrees in Nursing. Economics of Education Review, 21: 73-85.

Mertz EA, O'Neil E. (2002) The Growing Challenge of Oral Health in America. Health Affairs. 21(5) 65-77.

Orlans, Josh, Mertz, E, and Grumbach, K. (2002) Dental Health Professional Shortage Area Methodology: A Critical Review. San Francisco, CA: Center for the Health Professions, UCSF, October.

Franks PE, Chapman, SA, Nowicki, N and Mukherjea, A. Trends, Issues, and Projections of Supply and Demand for Nursing Aides and Home Care Aides: California Fieldwork. UCSF Center for the Health Professions, March 2002.

Miller, J, Grumbach, K and Mertz, E. Nursing for the Public's Health: A Profile of Public Health Nurses in Five California Counties. San Francisco, CA: Center for California Health Workforce Studies, University of California - San Francisco, December 2002.

Personnel


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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Center for Nursing Research and Innovation (CNRI)

The Center for Nursing Research and Innovation (CNRI) is a joint venture between UCSF School of Nursing and Patient Care Services at UCSF Medical Center, Stanford Hospital and Clinics, Lucile Salter Packard Children's Hospital and John Muir-Mount Diablo Medical Center.

The Center facilitates research across sites, fosters the capacity to interpret, apply and conduct research that improves patient care quality, safety, cost and outcomes, and strengthens the scientific validity and effectiveness of patient care practices through consultation and education that contributes to improving nursing practice, patient care and organizational performance.

CNRI Web Site

http://nurseweb.ucsf.edu/conf/cripc

The Center is currently conducting several studies:

  1. The Collaborative Alliance for Nursing Outcomes (CALNOC, formerly known as the California Nursing Outcomes Coalition) Investigative Team leadership has been coordinated by the Center since 1999. One of the first six ANA state-based nursing quality research & development projects, CALNOC is the largest ongoing statewide nursing quality measurement and repository development project in the nation. Through CALNOC, 130+ acute care hospitals voluntarily submit standardized nursing quality data to the CALNOC database managed by the Burns and Allen Research Institute at Cedars Sinai Medical Center, Los Angeles. In coordinating and facilitating the work of the CALNOC Investigative Team (N Donaldson and D. Brown, Co-Principal Investigators) the Center collaborates with hospital sites and stakeholders statewide while contributing to and advancing the ongoing CALNOC research agenda.
  2. CALNOC Interdisciplinary Nursing Quality Research Initiative (INQRI) Project Impact of Medical Surgical Acute Care Microsystem Nurse Characteristics and Practices on Patient Outcomes. Support for this study was provided by a grant through the Interdisciplinary Nursing Quality Research Initiative, a national program of the Robert Wood Johnson Foundation. The aim of this 2 year study is to develop a model examining the effects of unit level nurse workload, workforce characteristics and selected care processes on nurse sensitive outcomes in acute care medical-surgical units. The CALNOC outcomes studied are (1) incidence of falls and fall related injuries, (2) prevalence of hospital acquired pressure ulcers (HAPU), (3) prevalence of medication administration errors, (4) prevalence of peripherally inserted central catheter (PICC) associated blood stream infections, and (5) Stage 3 and 4 Pressure Ulcer Incidence. Integrating HAPU incidence, a publicly reported indicator, into the CALNOC dataset will enable study of the association between HAPU prevalence and incidence, as well as the sensitivity of both HAPU measures to variation in nurse workload, and the predictive power of early stage prevalence for HAPU late stage incidence.
  3. CALNOC Best Practices Study. At the request of member hospitals, CALNOC is exploring factors associated with best performing hospitals in regards to preventing falls and pressure ulcers. Phase I of the study, conducted in 2007, involved identifying hospitals in the lowest (best performing) quartile and the highest (worst performing) quartile from those in our 2006 database. Using qualitative methods, CALNOC investigators interviewed principals in some of each category to identify structures and processes that may be critical to achieving best performance. The results of those interviews were used to develop a survey designed to validate these findings. Selected CALNOC member hospitals have been asked to participate in this second phase, begun in May 2009. The results of this study may help identify best practices suitable for spread to other member hospitals. Preliminary results are expected in July, 2009.
  4. LPCH Medication Accuracy Study. Nurses and others at Lucile Packard Children’s Hospital (LPCH), under the direction of Annette Nasr RN, PhD, Nurse Scientist and Project Principal Investigator, are working with Nancy Donaldson, to examine the effects of a computerized physician order entry (CPOE) and computerized nursing documentation on medication administration accuracy in the pediatric population. Medication errors pose significant threats to this vulnerable population, and there is limited research available related to the epidemiology and prevention of medication errors in the pediatric population, although there is emergency evidence on the effects of CPOE on medication accuracy. This study is being supported by a $35,000 grant from the LPCH Pediatric Research Fund, indicating a strong commitment on the part of LPCH to building capacity for research and making it integral to patient care excellence.
Personnel

The Director of the Center is Nancy Donaldson, RN, DNSc, FAAN;  Associate Director is Mary Foley, MS, RN;  Susan Shapiro, RN, PhD, is our Senior Nurse Scientist;  Donna Frantz is the Administrative Analyst at our Stanford Satellite Office;  and Richard Ching is our Financial Analyst.

Contact Information

Nancy Donaldson, RN, DNSc, FAAN, Director
2 Koret Way, #N-631C, Box 0610
San Francisco, CA  94143-0610
Telephone:  (415) 502-1826      Fax:  415-476-8899
Email: nancy.donaldson@nursing.ucsf.edu

Mary Foley, MS, RN, Associate Director
Telephone:  (415) 514-3638       Fax:  415-476-1644
Email:  mary.foley@nursing.ucsf.edu

Susan Shapiro, RN, PhD, Senior Nurse Scientist
Telephone:  (415) 476-2926       Fax:  415-476-8899
Email:  susan.shapiro@nursing.ucsf.edu

Donna Frantz, Administrative Analyst
CNRI Satellite Office (at Stanford Hospital/Clinics)
900 Welch Road, #206
Stanford, CA  94305
Telephone:  (650) 723-7062       Fax:  650-725-0446
Email:  dfrantz@stanfordmed.org

Richard Ching, Financial Analyst
Telephone:  (415) 476-1643      Fax:  415-476-8899
Email:  richard.ching@nursing.ucsf.edu


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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Electrocardiographic Monitoring Research Laboratory

Barbara J. Drew, RN, PhD, FAAN, Director and Principal Investigator

Mission

The Electrocardiographic Monitoring Research Laboratory seeks to improve the diagnostic accuracy of electrocardiographic (ECG) monitoring for cardiac arrhythmias and myocardial ischemia and to promote innovative monitoring applications for patients in hospital, pre-hospital, and home settings.

Funding

National Institutes of Health: National Institute of Nursing Research and
National Heart, Lung, and Blood Institute

Publications

Drew, B.J., Wung, S.F., Adams, M.G., Pelter, M.M. Bedside diagnosis of myocardial ischemia with ST segment monitoring technology: Measurement issues for real-time clinical decision-making and trial designs. Journal of Electrocardiology, 1998, 30:174-181.

Drew, B.J. For the ST-Segment monitoring Practice Guideline International Working Group. Multilead ST-Segment monitoring in patients with acute coronary syndromes: A consensus statement for healthcare professionals. American Journal of Critical Care, 1999, 8: 372-386.

Drew, B.J., Pelter, M.M., Wung, S.F., Adams, M.G., Taylor, C., Evans, G.T., Foster E. Accuracy of the EASI 12-lead electrocardiogram compared to the standard 12-lead electrocardiogram for diagnosing multiple cardiac abnormalities. Journal of Electrocardiology, 1999, 32, 38-47.

Wung, S.F., Drew, B.J. New electrocardiographic criteria for posterior wall acute myocardial ischemia validated by a percutaneous transluminal coronary angioplasty model of acute myocardial infarction. American Journal Cardiology; 2001, 87: 970-974.

Drew, B.J., Pelter, M.M., Adams, M.G. Frequency, characteristics, and clinical significance of transient ST segment elevation in patients with acute coronary syndromes. European Heart Journal; 2002, 23: 941-947.

Pelter, M.M., Adams, M. G. & Drew, B.J. Association of transient myocardial ischemia with adverse in-hospital outcomes for angina patients treated in a telemetry unit or a coronary care unit. American Journal of Critical Care, 2002, 11(4), 318-325.

Drew, B.J. Celebrating the 100th birthday of the electrocardiogram: Lessons learned from research in cardiac monitoring. American Journal of Critical Care, 2002, 11(4), 378-386. Distinguished Research Award Lecture, AACN's National Teaching Institute, May, 2003, San Antonio, TX.

Pelter, M.M., Adams, M. G. & Drew, B.J. Transient myocardial ischemia is an independent predictor of adverse in-hospital outcomes in patients with acute coronary syndromes treated in the telemetry unit. Heart and Lung, 2003, 32:71-78.

Personnel

Michele M. Pelter, RN, PhD Coordinator Ischemia Monitoring Lab

Jessica Zegre, RN, BSN Project Director IMMEDIATE AIM Study

Claire Sommargren, RN, PhD, Co-Project Director, ST SMART Study

Elise Dempsey, RN, MS, Co-Project Director, ST SMART Study

Contact Information

UCSF Electrocardiographic Monitoring Research Laboratory
2 Koret Way, #N-631, Box 0610
San Francisco, CA, 94143-0610

Telephone:  415-476-7064       Fax:  415-476-8899
Emails:  Barbara.Drew@nursing.ucsf.edu,
Michele.Pelter@nursing.ucsf.edu, Jessica.Zegre@nursing.ucsf.edu,
sommargren@att.net, edempse@chw.edu



RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Cardiovascular Laboratory of Nutrition and Genetics

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The Cardiovascular Laboratory of Nutrition and Genetics

Investigators

Mary B. Engler, PhD, RN, MS
Marguerite M. Engler, PhD, RN, MS

The Cardiovascular Laboratory of Nutrition and Genetics activities include investigations on diet and dietary supplements and their effects on vascular endothelial function (brachial artery flow-mediated dilation), blood lipid levels, blood pressure, oxidative stress status, immune function, and possible associations with genetic variants. The genetic cause of HDL deficiency as a risk factor for atherosclerotic heart disease is also a primary focus of the laboratory.

Major Accomplishments

Early experimental studies with the omega-3 fatty acids, docosahexaenoic and eicosapentaenoic, demonstrated specific mechanisms of vascular relaxation and blood pressure lowering in models of cardiovascular risk, i.e., hypertension. Subsequent clinical trials showed that dietary supplementation with either docosahexaenoic acid or antioxidant vitamins improve vascular endothelial function in hyperlipidemic children at high risk for coronary artery disease; and improved vascular endothelial function in healthy adults following 2 weeks intervention with a flavonoid-rich dark chocolate (derived from the plant Theobroma cacao). These findings suggest an important role for nutrition in the prevention and treatment of atherosclerotic disease.

Current Grant Support

Engler, M.M., Malloy, M.J., Mietus-Snyder, M., Engler, M.B., Kennedy, C., Kools, S.M. "Diet, Endothelial Function, and Pediatric Hyperlipidemia." National Institute for Nursing Research, NHLBI, National Institutes of Health. R01 NR04902, Funding Period 4/1/00-12/31/04.

Engler, M.B. Phospholipid Transfer Protein Mutations In Dyslipidemias". National Institute for Nursing Research, National Institutes of Health. K01 Mentored Research Scientist Development Award, K01 NR07888, Funding Period 2/01/02-1/31/05.

Engler, M.B. "Effects of Chocolate Consumption on Oxidative Stress and Endothelial Function". University of California, San Francisco, School of Nursing.

Recent Publications

Engler, M.M., Bellenger-Germain, S.H., Engler, M.B., Narce, M.M., Poisson, J.-P. (2000). Dietary docosahexaenoic acid affects stearic acid desaturation in spontaneously hypertensive rats. Lipids, 35(9):1011-1015.

Engler, M.B., Engler, M.M. (2000). Docosahexaenoic acid-induced vasorelaxation in the hypertensive rat: mechanisms of action. Biological Research for Nursing, 2:(2), 85-95.

Engler, M.B., Engler, M.M., Browne, A., Sun, Y.P., Sievers, R. (2000). Mechanisms of vasorelaxation induced by eicosapentaenoic acid (20:5n-3) in WKY rat aorta. British Journal of Pharmacology, 131:(8), 1793-1799.

Engler, M.M., Engler, M.B., Malloy, M.J., Chiu, E. Y., Schloetter, M.C., Paul, S.M., Stuehlinger , M., Lin, K. Y., Cooke, J.P., Morrow, J.D., Ridker, p.M., Rifai, N., Miller, E., Witzum, J. L., Mietus-Synder, M.L. (2003, In press). Antioxidant vitamins C and E improve endothelial function in children with hyperlipidemia: Endothelial assessment of risk from lipids in youth (EARLY) study. Circulation.

Mietus-Snyder, M., Aouizerat, B., Engler, M.M., Engler, M.B., Chiu, E.Y., Malloy, M.J. (2002). Paraoxonase 1 status in pediatric hyperlipidemia: Genotype modulates activity. The Physiologist, 45(3):74.

Engler, M.M., Engler, M.B., Malloy, M.J., Chiu, E.L., Schloetter, M.C., J.P., Morrow, J.D., Rifai, N., Ridker, P.M., Mietus-Snyder, M. (2002). Docosahexaenoic acid, an omega-3 fatty acid, improves endothelial function in hyperlipidemic children: Endothelial assessment of risk from lipids in youth (EARLY) study. Circulation, 106(19):II-368.

Engler, M.M., Engler, M.B., Pierson D.M., Molteni, L.B., Molteni A. (2003). Effects of docosahexaenoic acid on vascular pathology and reactivity in hypertension. Experimental Biology and Medicine, 228:299-307.

Engler, M.B., Engler, M.M., Malloy, M.J., Browne, A., Chiu, E., Chen, C.Y., Milbury, P., Blumberg, J., Mietus-Snyder, M. (2003). Effects of flavonoid-rich chocolate consumption on endothelial function and oxidative stress (abstract). The FASEB J 17(5), Part I

Personnel

The personnel in the Laboratory: two Principal Investigators, Research/Lab assistants, Nurse coordinator, Project Director, and Masters/Doctoral Students.

Contact Information

Mary B. Engler, PhD, RN, MS, Professor
Dept. of Physiological Nursing
2 Koret Way, Suite N631
San Francisco, CA. 94143-0610
Phone: 415-476-0984      Fax:  415-476-8899
Email: mary.engler@nursing.ucsf.edu



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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

Genetics (Genomics) Research Program

Collaborating Investigators

The Genetics Program is centered on understanding the quantitative genetics (genomics) of common human disease to accelerate the translation of discoveries in basic science genetics (the bench) to clinical practice (the bedside).

Current Projects / Practice

Projects include a study of the role of common genetic variations in dyslipidemia, a risk factor for cardiovascular diseases. Research currently focuses on four clinical populations with discrete cardiovascular diseases: familial combined hyperlipidemia, hypoalphalipoproteinemia, hyperalphalipoproteinemia and normolipidemic controls. Studies also address the impact of these same genetic variants on insulin resistance-related phenotypes, such as diabetes, obesity and non-alcoholic steatohepatitis.

Major accomplishments

Successful identification of several candidate genes that play a role in familial combined hyperlipidemia, hypoalphalipoproteinemia and non-alcoholic steatohepatitis have expanded our understanding of the heritable underpinnings of these diseases. Investigators have identified mutations resulting in altered lipoprotein profiles within the following genes: the peroxisome proliferator-activated receptor alpha (PPARA) gene, the apolipoprotein A5 (APOA5) gene, the ATP-binding cassette transporter 1 (ABCA1) gene, and the adiponectin (apM-1) gene.

Current Grant Support
Recent scientific presentations and publications
Program staff

Medha Kulkarni, PhD

Yanina Natanzon, BS

Contact Information

Bradley Aouizerat, PhD
UCSF School of Nursing, Box 0610
2 Koret Way #N725
San Francisco, CA 94143-0610

Telephone: 415-476-9534 (Lab)      Fax:  415-476-8899
Email:  bradley.aouizerat@nursing.ucsf.edu



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RESEARCH · SCHOOL OF NURSING · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO 

International Center for
HIV/AIDS Research and Clinical Training in Nursing

Leadership
Overview

The International Center for HIV/AIDS Research and Clinical Training in Nursing is an inter-departmental and multi-disciplinary effort, committed to research, education, and care of persons with HIV.

The mission of the Center is to enhance optimal health and quality of care for people living with, at risk for and affected by HIV/AIDS through nursing leadership in research, clinical practice and education.

Center Web Site
Contact Information

William Holzemer
2 Koret Way, Box 0608
San Francisco, CA 94143-0608

Telephone:  415-476-2763     Fax:  415-476-6042
Email:  bill.holzemer@nursing.ucsf.edu



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