1. Cameron Smith
HSC 4700, Fall 2015
Horizons From the Road

2. PRELUDE PAGE #
TITLE PAGE 1
TABLE OF CONTENTS 2-3
INTRODUCTION 4
I – TECHNICAL REPORT
CASE SCENARIOS
-Case Scenario #1 5-6
-Case Scenario #2 7-8
-Case Scenario #3 9-10
-Case Scenario #4 11-12
-Case Scenario# 5 13-14
JOURNAL REVIEWS
-Journal Review #1 15-17
-Journal Review #2 18-20
-Journal Review #3 21-23
-Journal Review #4 24-26
HEALTHCARE PROFESSIONAL INTERVIEW
-Healthcare Professional Interview Paper 27-29
NAMES OF JOURNALS
-Names of 5 Scientific Journals 30
SAMPLES OF PREVIOUS WORK
-CHRP 31-42
-Empirical Article Report 43-48
-Research Paper 49-57
II – CAREER SEARCH
JOB ADVERTISEMENT
-Job Advertisement 58-59
COVER LETTER
-Cover Letter 60
RESUME
-Resume 61-62
PERSONAL ESSAY
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3. -Personal Essay 63
III – SYSTEMS ANALYSIS
SYSTEMS ANALYSIS CHART
-Systems Analysis Chart 64
IV – PAPERS
LEGACY ROLE
-Legacy Role Paper 65
ALUMNI ROLE
-Alumni Role Paper 66-68
V – PHILOSOPHY
STATEMENT OF PHILOSOPHY
-Statement of Philosophy 69
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4. Introduction
This portfolio is a compilation of some of my best work as a health science
undergraduate at California State University, East Bay. The extensive time and effort needed to
succeed as a student are reflected in the various pieces included and allow the portfolio to serve
as a milestone in my career path. For convenience, future employers may quickly move between
easily defined sections and can embellish in a thorough attention to detail. Defined sections
include a technical report - comprising real-world case scenarios, reviews of scientific journals,
the interview of a healthcare professional, list of 5 scientific journals, and samples of previous
work. Next, a career search section will be found – including job advertisement, cover letter,
resume, and personal essay addressing readiness for employment. A systems analysis section
includes a real-world hierarchy of a healthcare system to demonstrate understanding of how
organizations intricately piece together to form a working unit. The legacy and alumni role
section includes papers demonstrating knowledge of the rationale behind the health science
undergraduate program and my commitment for furthering my medical career. Finally, the
statement of philosophy section will be found and represents my personal commitment to
applying lessons learned in the health science program to my own life in an attempt to live
healthy and well.
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5. Cameron Smith 10/03/2015, HSC 4700
Case Scenario #1: As the health educator on campus, you know that students procrastinate in
accessing the resources they need on campus like academic advising, career planning, attending
instructor office hours, buying required text books, etc. What strategies would you develop to
assist students succeed in college?
1) Extra Credit Incentive: Students often procrastinate until a due date or problem approaches
and see no benefits of early intervention actions. If instructors were to offer extra points to
students that had their materials early, proof that they had at least ordered them, or attended
office hours, the benefits would be more tangible to students. Instructors could also offer extra
credit for those that complete assignments earlier than the due date. By encouraging all freshman
instructors to agree with this policy, students will begin to habituate visiting office hours and
academic advising offices. This will best prepare them for a successful college career.
2) Develop Engaging Assignments: Students are much less likely to procrastinate if they find
the activity or assignment to be engaging and relatable to real world issues. Assignments that
may be deemed useful in students’ chosen career fields or that can be beneficial to the
development of a particular skill keep interest high. Video assignments and opportunities for
fieldwork also provide stimulation. Instructors that practice this should theoretically teach more
enthusiastic students with more passion towards their chosen major.
3) Provide Less Barriers: Classes that offer outside learning opportunities should provide more
support and guidance to their students. Students who try to take advantage of these opportunities
feel discouraged because the application processes are lengthy and tedious. Many programs
require various hurdles before approval is given, which can benefit those who are truly ready, but
can deter those who are simply thinking about applying. Departments should advertise
opportunities to give students the best learning environment possible.
4) Offer Group Pricing: If supplies such as textbooks or lab materials were offered at a
discounted group price, students would be encouraged to band together earlier to get cheaper
pricing. Also, this encourages new peer relationships, which can lead to study groups that can
ensue throughout the course. Professors can foster this by having a bookstore employee briefly
visit their class to explain group pricing, as well as inquiring about student interest.
5) Due Date Windows: When given a long-term assignment, provide a one to two week window
in which only certain students present their assignment each day. Students are chosen at random,
which necessitates that all students have the assignment done or risk losing points. Variations of
this method could include simply checking that students have at least begun an assignment or are
working at the correct pace needed to finish. Professors that implement this idea will see higher
compliance and motivation to complete the assignment sooner. Students are discouraged from
procrastinating on this type of assignment.
6) Free Coffee and Snacks: Instructors or advisors could find ways to offer free coffee and
snacks at times that students would normally be spending wandering around campus. To avoid
lines of students simply looking for freebies, punch cards could be distributed that would be
stamped upon arrival and 10 minutes later. Although realistically, it would be tough to watch
everyone, the rationale would be that if students were willing to spend time in the intended area,
they would at least attempt to be productive. Variations could include longer times between
stamps or more stringent provisions for proof of productivity, such as completed homework or
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6. even a few minutes of speaking to an advisor. These services could be provided at the AACE,
office hours and SCAA to encourage students to visit. They also could be provided during the
study nights offered in the Unions at Dead Week.
7) Lottery: Students are encouraged to attend office hours and career advising seminars by
receiving a prize if they are every fourth student to walk in the door. For events that are most
useful and beneficial for the students, the prizes can be more valuable and less frequent to
encourage attendance. The benefit for the instructor or advisor is that they could give away fewer
incentives, as opposed to the previous suggestion, while still giving students a reason to come.
To see if a student won or not, they would have to wait until the end of the meeting and thus
accomplished some degree of productivity. AACE or SCAA can assist in this plan by donating
some of their advertising materials (i.e. pens, notebooks, wristbands). They can also be
advertised on billboards around school to encourage attendance.
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7. Cameron Smith, 10/10/15, HSC 4700
Case Scenario #2: To ensure residents in your neighborhood save water due to the continuing
California drought, what strategies would you recommend?
1) Shower Usage: Bathrooms use a relatively high proportion of water in comparison to the rest
of a home. Showers represent a significant portion of this usage and by trimming time spent in
the shower, even by a few minutes, many gallons can be saved. An idea would be to pass out 5
minute timers to residents of the neighborhood, or in a more cost effective manner, suggest
residents set a timer on their cell phone. A pamphlet with shower usage statistics pertaining to
water usage, as well as ideas for reduction such as replacing a showerhead to one with a low
flow, could be distributed door to door.
2) Limit Watering: Residents wishing to water their lawn could reduce their usage to only
certain days and times of the week, agreed upon by members of the community. Applying spray
nozzles to hoses would limit the constant flow of water that traditional hoses sacrifice. For those
who choose not to water at all, a contest could be carried out in which the home with the
brownest lawn would win a prize or certificate. Members of the community could meet to decide
the times when watering would be acceptable, and by talking to local hardware stores, a deal to
provide discounted or free spray nozzles for hoses may be reached.
3) Car Washing: For those wishing to wash their car, spray nozzles would again decrease water
usage as opposed to a traditional hose spout. Ideas such as using a bucket of water to rinse, or
even going to a car wash where recycled water is used could also save. Members of the
community could spread ideas such as these by holding a monthly meeting, distributing flyers, or
simply by word of mouth when passing by someone washing their car outside.
4) Recycling Water: Residents could recycle water by placing a bucket underneath a sink or
showerhead as they wait for water to heat up. This water that would normally go to waste could
be utilized for things such as the previously mentioned car washing or lawn/plant watering. Ideas
such as these could be emailed to residents that opted for them, posted on telephone poles or by
word of mouth. Also, residents that save water in this matter could help and offer some to
neighbors if they cannot find a way to use all of it.
5) Dishwashing: By hand washing dishes, residents could save many gallons of water when
compared to using a dishwasher. This could be best accomplished by using a small amount of
water to get soap to bubble and only rinsing once all dishes have been scrubbed. Traditional
dishwashing, in which the water runs the entire time would not be as efficient and may come
close to dishwasher water usage. Residents could also limit dish usage in general by buying
paper plates and disposable utensils. These could be distributed in small quantities at community
meetings, or coupons for cheaper pricing could be handed out. Residents could also band
together to purchase in bulk and save even more money.
6) Laundry Efficiency: By washing larger loads when doing laundry, fewer loads are needed,
and thus less water is used. Residents could also wash less laundry by wearing clothing that does
not need washing as frequently, such as jeans or coats, for longer between washes. Residents
could learn about ideas such as these by attending community meetings, through email or by
word of mouth.
7) Repairing Leaks: Leaks can waste large quantities of water over time, no matter how small
they may seem. Identifying and putting a stop to them can substantially conserve water usage.
Members of the community that may be plumbers or even just have knowledge about repairing
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8. leaks could volunteer. Plumbers could offer free evaluations not only in an attempt to help the
community, but also to boost demand for their work. Those that are weary about paying for
repairs could minimize smaller leaks by simply placing plumbers tape around them or by turning
off sources of leaks sooner.
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9. Cameron Smith, 10/17/15, HSC 4700
Case Scenario #3: Commuters in your neighborhood have been trying to find ways to go to work
using environmentally friendly and sustainable ways. What ideas would you give them?
1) Bike to Work: Riding a bicycle to work can have numerous benefits not only for the
environment, but also for your health. Bicycles have no emissions and actually help the cyclist
stay in great physical shape. Traffic jams are nearly nonexistent when on a bicycle and
commutes can actually be faster than driving in many city situations. Employers could encourage
this method of commuting by offering free water and snacks once employees arrive; building
bicycle racks, or by offering a raffle with small incentives to those with choose to ride.
Community meetings will help spread the idea and spark interest in this method of commuting to
work. Employers will be notified by inviting a member of the management to the meeting, or by
posting flyers in employee common areas at work.
2) Join A Carpool: Carpools can be quite beneficial to all parties involved, as it allows normal
fuel/maintenance/parking costs to be divided among all individual passengers. Traffic congestion
is reduced by the amount of passengers present, as the cars that they would typically be driving
are off the road. Some bridges and toll roads allow special lanes for carpoolers at discounted
pricing and during peak traffic times, carpool/hov lanes can be utilized, resulting in a faster
commute. Employers can encourage this method of commuting by posting sign-up sheets in the
break room, holding appreciation events (i.e. a potluck) for members of carpools, or even
offering a company vehicle to use. Community meetings will help spread the idea and spark
interest in this method of commuting to work. Employers will be notified by inviting a member
of the management to the meeting, or by posting flyers in employee common areas at work.
3) Jog/Walk: Though it may seem cumbersome for many, it can be very rewarding both
physically and environmentally. Walking and jogging keep the body in great shape, so it can be
great for those who may work in sedentary, office-type jobs. Pollution is completely nonexistent,
as well as traffic jams, so commute times can be much more predictable. Individuals could find
out about ideas such as this via a company mass email, or by flyers posted in the break room.
Employers could encourage this mode of commuting by offering free coffee or snacks to
walkers/joggers, or by offering bonuses/incentives to those who give up their assigned parking
spot, it applicable. Community meetings will help spread the idea to employers and employees
alike. Employers will be notified by inviting a member of the management to the meeting, or by
posting flyers in employee common areas at work.
4) Take Public Transit: Public transit can be highly efficient in that commute times are mostly
predicable, special lanes in the city or on the highway are able to be utilized, pricing when
compared to driving can be much cheaper, and attention can be redirected from the usual task of
driving to catching up on more work or personal matters. Pollution still exists, but is still lower
than that produced by driving individually, since many people utilize it. Some government and
workplace programs exist that allot credits that can be used for the purchase of public transit
vouchers/tickets. This idea for commuting can spread by posting signs in workplace common
areas, via mass email, or simply by word of mouth. Appreciation events for employees that can
be cheap for the company can include potlucks for those that utilize this method, or even
bracelets/wristbands. Community meetings will further help spread the idea and employers will
be notified by inviting a member of the management to the meeting, or by being presented a
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10. PowerPoint from a member of the community.
5) Fuel Efficient Vehicles: By trading in an inefficient or older vehicle, for a more fuel efficient
one, commuters can not only save money on their commutes, but for certain vehicles,
government incentives can be quite rewarding. Many electric/hybrid vehicles receive rebates and
discounts that can dramatically lower the price of a vehicle and some even come with special hov
stickers that allow individual drivers to utilize carpool/hov lanes. Individuals interested in this
method could spread the word to others in the workplace via word of mouth, at a community
meeting, or by posting deals for cheap vehicles in workplace common areas. Employers will be
notified by inviting a member of the management to the meeting, via email, or by being
presented a PowerPoint from a member of the community.
6) Work Longer Days: By adopting a longer workday, you not only avoid traffic jams during
peak times, but you could also eliminate a workday from the week. By encouraging people to
speak with management, a typical 40-hour workweek could become a 4-day workweek by
working 4 ten-hour days, rather than 5 eight-hour days. If time spent at work would still be
equivalent, productivity would theoretically be the same, while spending less time driving to and
from work. Ideas such as this could be presented at a community meeting to spread the idea and
spark interest in this method of commuting to work. Employers will be notified by inviting a
company management representative to the meeting, or via email
7) Effects of Erratic Driving: Driving that includes excessive speed; abrupt maneuvers or quick
launches from a stop can have huge impacts on fuel economy. By teaching others about these
effects, fuel economy gains can be great. Commuters can learn more about these benefits via
word of mouth, or by flyers passed out at a community meeting. Employers will be notified by
inviting a company management representative to the meeting, or via email.
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11. Cameron Smith, 10/24/15, HSC 4700
Case Scenario #4: Understanding the importance of balanced nutrition for youngsters, describe
the strategies you would put forth to encourage parents to feed their children healthy food.
1) Plan Meals: By cooking meals as your appetite arises, convenience is likely to dictate over
healthiness. Parents can ensure a healthier intake for their own diet as well as their own by
planning meals ahead of time. This allows for all necessary food groups to be involved, cuts back
on the excessive amounts of sodium and fat that convenience foods offer, and makes mealtimes
less stressful. In this method, parents also teach their children that meals are only at certain
times, rather than every time the appetite arises, helping eliminate eating out of boredom or
excessive eating. Schools will be notified and community meetings will seek to bring
representatives from parents and school officials. One designated representative from each group
will be tasked with spreading the ideas via email, telephone, or word of mouth.
2) Practice What You Preach: During early childhood, a parent is one of their child’s largest
role models. By modeling healthy eating habits early on, children are better set to also adopt
them and aren’t as apt to make bad food decisions later on in life. Parents can model this
behavior by not excessively snacking between meals, consuming plenty of fruits and vegetables,
eating smaller portions and watching junk food intake, such as soda and candy. The school nurse
will be notified so that the school health office can administer flyers to parents at community
meetings or mail them out to homes. Representatives for parents and school faculty can be tasked
with spreading the word to those that they represent.
3) Cooking Together: By allowing a child to contribute to the process of food preparation, they
feel more involved and are curious to try what they helped create. Parents can make this fun by
allowing their child to use cookie cutters, making smiley faces in food, or by simply encouraging
their imagination, such as renaming or creating stories for foods. In general, healthy foods can
involve more preparation, which involves more time and effort spent, leading to a sense of
accomplishment. Many children may even find a new hobby in food preparation. Schools will be
contacted to spread information about this method and flyers can be distributed to parents upon
school approval via mail or at parent-teacher meetings.
5) Strike A Balance: Eating healthy food all the time, especially for children, is an unrealistic
goal. By striking a balance between healthy food and junk food, goals can be more attainable and
not seem like such a punishment. Healthy food should comprise most of the diet however to
ensure proper growth and development for the rest of a child’s life. Parents can set certain days
in which children can eat out at fast food restaurants, allow sweets only after certain meals or
times, and can simply purchase less junk food, so that it’s not as readily available. Ideas such as
this can be spread by seeking parents and faculty members to join a committee to represent the
larger group, which can then distribute them via word of mouth, flyers, email or door-to-door.
6) Introduce Dipping: Healthy foods may not always be the tastiest foods, hence why children
can be so apprehensive about consuming them. By introducing dips, such as peanut butter, salsa,
or ranch, children may find foods such as vegetables more delightful. Parents can experiment
with different dips during meals to encourage new habits. Schools will be notified either via
email or phone that ideas such as these need to be spread to parents. Upon approval, community
meetings can be assembled, with representatives from each group (parents and faculty members)
that can further spread the word. Also, members of the school faculty could pass out flyers when
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12. parents pick up their children after class.
7) Don’t Force Habits: Children can be very stubborn, especially when telling them that they
need to consume their fruits or vegetables. By adopting a more laid back approach and simply
placing these items on a plate alongside foods that they already love, children may become
curious and try them. Parents can facilitate this method by serving small amounts of healthy food
on their children’s plate, in the hopes that the child will finish what is on their plate before
reaching for more of the food that they already love. Schools can become aware of ideas such as
these by either emailing, calling, or meeting with school administrators to present a PowerPoint.
Upon approval, a community meeting or parent-teacher conferences can help further spread the
word.
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13. Cameron Smith, 10/31/15, HSC 4700
Case Scenario #5: As a manager of a nursing home downtown, your assistants tell you that most
seniors at the facility appear depressed and living very stressful and disturbed lives. Describe
how you would address this problem.
1) Needs Assessment: To first get a sense of what the residents seem to be lacking, a needs
assessment would be conducted. Depending on the size of the community living in the nursing
home, either all residents could participate, or a sample that is large enough to be representative
of the population, as a whole would be selected. A mixture of quantitative and qualitative
questions would be asked to not ensure complete accuracy and to extract enough information
from the residents. The assessment could be offered as a questionnaire, with staff on hand to
properly listen to key points and take notes from residents.
2) Evaluation: After completion of the needs assessment, the results would be analyzed for
changes that need to be made. Proper implementation would entail taking into account
everyone’s concerns and finding ways to help ameliorate them. Ideas such as the following could
be potentially beneficial, depending on the needs and concerns of residents. Needs assessments
should be conducted on regular intervals to ensure ideas have been effective.
3) Karaoke: Oftentimes in nursing homes, residents can be objectified and forgotten as actual
people with personalities. In this activity, residents that are able to sing can remember their
younger selves and liven the atmosphere, whereas residents that aren’t able to can still enjoy the
fun and music as well. The idea can be implemented by tasking assistants to buy the materials
needed (if within the budget), or by utilizing existing materials, such as computers or television
screens to display lyrics. To get a sense of which songs to include, assistants could conduct a
survey among the residents.
4) Entertainment Hour: Residents sometimes lose touch with the outside world and all the
great things that it has to offer. By offering a time slot in the day with snacks and drinks other
than those offered daily (while still within the constraints of dietary restrictions) and an
entertainer, such as a magician, storyteller, or singer, residents can reclaim some of the things
they used to enjoy. To help implement this idea, assistants could be tasked with finding snack
and drink ideas for those with each type of dietary restriction that haven’t been offered before, or
that are rarely offered and purchase them if within the budget. If not within the budget, assistants
could instead volunteer to bring goods from home for a potluck-type experience. The entertainer
could be found by tapping into any employee connections, or even by asking for an employee
that would like to volunteer.
5) Children: Residents will often see the same faces day in and day out, with little to no contact
with their loved ones in many cases. Children are thus a group that they become isolated from,
and it becomes easier to feel their age with every passing day. By petitioning a local elementary
school or preschool for volunteers to donate handmade cards or letters to residents, they can feel
more connected to the world and feel that they truly matter. Alternatively, if any employees have
children, they could volunteer to bring them by to visit residents (while within the constraints of
resident safety and comfort).
6) Lively Atmosphere: The atmosphere of a nursing home can become quite dreary for those
that must live there for long periods of time or indefinitely. By decorating common areas as well
as rooms in which residents agree (to not upset them, especially those with Alzheimer’s), the
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14. change of atmosphere can have a positive effect on their attitude. Choosing warm, welcoming
colors, blowing up balloons, and using seasonal appropriate decorations, residents can be
reminded that they are at home. This idea can be implemented in many different ways, and can
be decided upon during an employee meeting or via surveys in break rooms. Employees can
volunteer to bring in decorations, or can vote on which decorations to buy (while keeping within
the budget).
7) Outdoor Activities: Along the lines of the previous suggestion, residents can often become
depressed or have anxiety due to their never-changing environment. By allotting time for outside
activities such as having a picnic, bird watching, storytelling, or even a simple walk, residents
can be reminded that their environment doesn’t have to be static. This idea can be quite simple to
implement, as it costs little to no money. Events such as a picnic can be substituted for an indoor
meal, and can be implemented ahead of time by cleaning tables outside, setting up an umbrella
for shade, and gathering necessary supplies. Employees can vote on which activities to include at
a staff meeting, and the director can offer suggestions such as the ones given.
8) Auction: Residents can participate in an auction to stimulate socialization, gain a sense of
decision-making and to simply have fun. Auction items can be purchased from a dollar store,
handcrafted by employees/volunteers or can be intangible, such as a storytelling from an
employee. Money for the auction need not be real and can be provided via a Monopoly currency,
or pennies donated by employees. Auction items can be voted on in a staff meeting and ideas can
come from both residents (via survey or word of mouth) and employees.
9) Games and Puzzles: As residents age, their brain function if not properly stimulated can
decline at a very rapid rate. By offering games such as BINGO, Dominoes, Yahtzee, or mildly
challenging puzzles, their brains can be stimulated and they can have fun and can socialize with
other residents or assistants in ways they don’t normally get to. This idea can be implemented by
voting on which games/puzzles to include during staff meetings, or by polling residents.
Depending upon which games/puzzles are chosen, a budget can be made for purchasing them, or
employees can be asked for donations of games/puzzles they no longer use.
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15. Foodborne Illness
Medical technology has advanced at a steady pace as society has become more
technologically dependent and discovers innovative approaches in the preservation of health. In
spite of this rapid advancement however, food safety has not followed suit and consequently,
foodborne illness continues to occur and pose danger to public health. Various reasons for this
trend exist and could potentially include an increase in global travel and food supply, changes in
food preference, increased consumption of restaurant food, and an ever-changing microbe
population. (Alexander, L.L., 2012, p.3)
The most common culprits in inducing foodborne illness have been identified as
infectious agents such as bacteria, viruses, or in more rare instances, parasites. Heavy metals and
toxins found in nature, especially those found in ocean life also contribute. (Alexander, L.L.,
2012, p.3) Changes in food preference, such as an increase in fruit and vegetable consumption,
have fueled the spread of such agents, as they are more prone to harboring them.
One of the most obvious indicators of foodborne illness has been identified as
gastrointestinal problems, which includes diarrhea, vomiting, and cramps. (Alexander, L.L.,
2012, p.4) These symptoms are encountered when food or water has been contaminated with the
aforementioned bacteria or parasites and then ingested. Viruses are an exception, as they can
survive for longer periods of time and are thus spread differently - primarily through the fecal-
oral route.
Proper knowledge of emerging trends in foodborne illness is chief in both the prevention
and treatment of such illness. Knowledge is obtained as increasing encounters with infectious
agents occur and are reported to public health agencies in a timely fashion. As trends are
identified, the proper measures can be taken to curtail further spread and inform medical
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16. professionals. As agents within the medical field, practitioners and medical staff have the ability
to intervene earlier when equipped with this knowledge and correctly diagnose and treat patients
before serious illness can occur.
Issues that can complicate identification and thus proper knowledge of trends can include
under-reporting, difficulties in recognizing symptoms, inabilities to identify mode of
transmission, the emergence of novel pathogens, and misdiagnoses. (American Medical
Association, American Nurses Association, 2004, p.3) When practitioners and medical staff
become aware of these issues in identification, they can more readily prepare to encounter them
and avoid contributing such difficulties.
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17. References
Alexander, L. L. (2012). Foodborne Illness. [PDF document]. Retrieved from
http://www.netce.com/coursecontent.php?courseid=879
American Medical Association, American Nurses Association—American Nurses
Foundation, Centers for Disease Control and Prevention, Center for Food Safety
and Applied Nutrition Food and Drug Administration, Food Safety and Inspection
Service U.S. Department of Agriculture. Diagnosis and management of foodborne
illnesses: a primer for physicians and other health care professionals. MMWR.
2004;53(RR4):1-33.
Centers for Disease Control and Prevention. Preliminary FoodNet data on the incidence
of infection with pathogens transmitted commonly through food—10 states, 2009.
MMWR. 2010;59(14):418-422.
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18. Burnout: Impact on Nursing
Originally coined in the 1940’s, the term burnout referred to the point at which a jet or
rocket engine ceased to possess the ability to operate. The term later was applied to humans to
describe a complete loss of energy, purpose, and motivation as a result of working. (Edelwich,
Brodsky, 1980) Burnout can occur in nearly any job setting, but has been found to be most
prevalent in settings that require high levels of helping others, such as the medical field. Within
the medical field, Nursing has been identified as a branch with very high prevalence, mostly due
to the nature of the work environment.
The work environment for Nurses places them in high levels of patient interaction and
can often include stressful situations that need to be diffused in a time-efficient manner.
Overtime and extended shifts are commonplace within the field and such high levels of human
interaction leave little time for self-reflection and coping. Hierarchy among those in the medical
field can also create tension, as Physicians often dominate decision making, leaving less room
for autonomy. (Alexander, L.L., 2012) Nurses that work in skilled nursing facilities and hospitals
have been found to possess the highest rates of job dissatisfaction, mostly attributable to
inadequate staffing, coworker conflicts, and low pay. (Alexander, L.L., 2012)
Consequences of chronic burnout can be severe and can impact the well being of both
Nurses and patients. Personal consequences for Nurses can include diminished social support
outside of work, substance abuse, and feelings of depression. These consequences interact with
workplace performance and subsequently create professional consequences. Workplace
attendance, productivity, and quality of patient care often diminish and can place patient safety in
danger. (Alexander, L.L., 2012) Nursing shortages interact with professional consequences, due
to the fact that staff is not large enough to compensate when burnout occurs.
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19. The current crop of baby boomers that are approaching retirement and thus a point in
which health problems are generally more prevalent, highlights the issues involved with the
current burnout among Nurses. Inadequate staffing will continue to fuel burnout as workloads
increase and perpetuate a cycle in which Nurses are forced to leave their jobs due to
dissatisfaction. (Buerhaus, Auerbach, & Staiger, 2009) With fewer Nurses available to provide
care, patient outcomes will suffer, and place more strain on the medical field than is already
present. As a future member of the medical field, my responsibilities in combating burnout
among Nurses is to be aware of the strain placed upon them and offer help and compassion when
possible. The medical field operates most efficiently when all members that contribute to patient
care can successfully perform their job, and by helping others understand the prevalence, the
level of burnout can be minimized.
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20. References
Alexander, L. L. (2012). Burnout: Impact on Nursing. [PDF document]. Retrieved
from https://www.netcegroups.com/827/Course_3143.pdf
Buerhaus P, Auerbach D, Staiger D. The recent surge in nurse employment: causes and
implications. Health Aff. 2009;28(4):w657-w668.
Edelwich J, Brodsky A. Burn-out: Stages of Disillusionment in the Helping Professions.
New York, NY: Springer; 1980.
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21. What Healthcare Professionals Should Know About Exercise
Obesity has achieved epidemic status in today’s society, as Americans focus more on
their busy lives than on taking care of their health. Despite widespread knowledge of the benefits
of exercise, the vast majority of Americans participate either too little or not at all. (Centers for
Disease Control and Prevention, 2008, p. 1) Physicians have the opportunity to intervene and
influence patients to reach exercise goals, however most are ill equipped to offer practical advice
on the subject. (White, J. J., 2010)
Various reasons exist for a lack of exercise and Physicians need to be aware of how to
deal with each as they arise. Reasons most often include a lack of interest, busy schedules, lack
of time, fear of injury, lack of proper techniques and methods, and lack of access to facilities or
equipment. To help patients overcome these burdens, the United States Preventative Services
Task Force recommends that Physicians begin by identifying obese patients and offering both
counseling and behavioral interventions. (White, J. J., 2010) Adequate counseling is established
as at least 1-2 sessions per month for higher risk patients, while all patients, regardless of risk
should be counseled for at least 5 minutes every appointment.
In terms of patient safety, those over the age of 35 that have been primarily sedentary for
an extended period of time should be cleared before beginning an exercise regimen. (The
President’s Council on Physical Fitness and Sports, 2008) In most other cases, the willingness
alone should be sufficient to begin exercise, with a physical exam just to confirm overall health.
After safety has been established, Physicians should focus attention on both short term and long
term goals that are reasonable yet effective. With proper goals, patients should be able to see
results within the short term including moderate weight loss and strength gain, and should
continually improve endurance and motivation in the long term. (White, J. J., 2010) A proper
21

22. exercise regimen should also identify all barriers to exercise so that both the Physician and
patient can work together to overcome them as they arise.
As a future member of the healthcare field, I need to be conscious of both my own level
of exercise and risk for obesity as well as my patients. I can focus on eating healthier and finding
realistic ways to incorporate exercise into my daily life by setting both short and long terms
goals. Those who are passionate about something tend to pass it on easier to others than those
who don’t tend to care. Patients are more likely to listen to someone that understands struggles
and limitations and that can help them move past them. In order for the obesity epidemic to stop
growing, healthcare providers need to possess a complete picture of the situation and understand
factors beyond the scientific and statistical ones so thoroughly stressed, beginning with the
aspect of being human.
22

23. References
White, J. J. (2010). What Healthcare Professionals Should Know About Exercise. [PDF
document]. Retrieved November 22, 2015, from
http://www.netce.com/coursecontent.php?courseid=994
Centers for Disease Control and Prevention. (2008) Prevalence of Self-Reported
Physically Active Adults—United States, 2007. Retrieved November 22, 2015,
from http://www.cdc.gov/nccdphp/dnpa/physical/stats/leisure_time.htm.
The President’s Council on Physical Fitness and Sports. Fitness Fundamentals:
Guidelines for Personal Exercise Programs. (2008) Retrieved November 22, 2015,
from http://www.fitness.gov/be-active/physical-activity-guidelines-for-americans/
23

24. Basic of Bacterial Resistance
With the advent of antibiotics in the early 1940’s, humankind gained the ability to
successfully combat infectious diseases that previously ended in death for those afflicted. In a
similar fashion however, bacteria was also able to evolve, and resistant strains began appearing
shortly thereafter. Resistance continues to be an increasingly large threat due to an over abundant
usage of antibiotics for most medical-related needs. When used correctly, the technique of
specific therapy is applied, and implies that the infecting agent has an identified susceptibility to
the drug being used. (Shenold, C., 2011) Empiric, or broad-spectrum therapy is typically when
resistance problems begin to arise though, due to the lack of knowledge of the infecting agent.
This lack of knowledge dictates usage of an antibiotic that can disrupt normal intestinal bacteria
and allow resistant bacteria to flourish. (Shenold, C., 2011)
Resistant bacteria often begin flourishing in large, populous areas, where contact between
people is high and thus allows easier spreading. Compounding this is society’s ability to travel
rapidly between areas in a short amount of time, as evident in the relatively minimal amount of
diverse strains. Nearly 85% of strains encountered in the hospital setting include Staphylococcus
aureus, Enterococcus, Escherichia coli, and Pseudomonas aeruginosa, all of which can be
commonly encountered in everyday life. (Stokowski, L., 2010)
Despite a strict set of guidelines enacted to detect, prevent, and control resistant bacteria
by the Centers for Disease Control (CDC), proliferation still continues due to societal preference
for antibiotic misusage. When prescribed and used to eradicate infection, patients often stop
usage when symptoms have subsided, allowing remaining bacteria to continue living and thus
build resistance. In certain areas of the world, antibiotics are available without prescription,
allowing those who may not even need them to treat themselves and also enabling bacteria to
24

25. grow resistance. Farmers have found that antibiotics can enhance growth in animals, thus leading
to larger profits, but the similar misusage again allows for resistance to form among bacteria and
can be spread to humans upon consumption. (Stokowski, L., 2010) Finally, many people upon
falling ill demand some form of drug treatment, and are often wrongly prescribed antibiotics.
As an active, contributing member of the medical field, I will no doubt encounter patients
with antibiotic resistant bacteria, as well as patients that misuse antibiotics and the accompanying
Physicians that prescribe them. I need to be aware of the dangers of such bacteria, due to the
serious health implications they pose, and help coach others of the precautions necessary when
dealing with them. Failure to do so can result in an unsafe workplace, and can contribute to a
much more dangerous epidemic among all members of society. Future research should focus on
methods of controlling antibiotic usage better and limiting availability of new antibiotics to a
slower pace.
25

26. References
Shenold, C. (2011). Basics of Bacterial Resistance. [PDF document]. Retrieved
November 26, 2015, from http://www.netce.com/courseoverview.php?
courseid=1029
Stokowski, L. (2010). Antimicrobial Resistance: A Primer. Retrieved November 26,
2015, from http://www.medscape.com/viewarticle/729196
26

27. HSc 4700 - HEALTHCARE PROFESSIONAL
INTERVIEW (50 pts)
Date of Interview: 10/23/15
Healthcare Professional’s Name: Nancy Cook
Professional Title: Nurse Practitioner, Registered Nurse (POM/Pre-Op)
Affiliated Institution: Kaiser Permanente
Contact Phone: (510) 454-7600 E-mail: Nancy.E.Cook@kp.org
1. Please introduce yourself and state the purpose of the interview.
My name is Cameron Smith and I am a graduating senior at Cal State East Bay majoring in
health sciences. I am doing this interview to learn about your professional training for this job,
your work experiences and hopefully, get some career tips as I prepare to enter the work
environment. This interview is also a partial fulfillment of the requirements of my final course in
the health sciences program.
2. Please tell me how you were professionally trained for this position?
I began my training by first receiving my BSN or Bachelors of Science in Nursing. Within about
a year, I got my first job as an RN (Registered Nurse), working part time at a hospital. I began
my program to become an NP (Nurse Practitioner) after about 8 years as an RN, working
primarily in the ICU (intensive care unit). The NP program focused on Adult and Acute Care,
which is no longer offered, but has since been replaced with gerontology.
3. Is there anything else that may have helped you get this job, like an internship, volunteer
work, or any other special skills you have?
I attended school in a relatively rural part of Kentucky, where RNs were highly needed at the
time; so becoming an RN and subsequently an NP were not too competitive. In fact, they almost
had to compete for me since the need for nurses was so immense. The job market for nurses isn’t
quite as readily open as it was, since the field is now booming with new nurses, but when I was
going to school, there was a severe shortage.
4. What are your job duties and responsibilities?
I actually have duties that pertain to an RN as well as an NP. As you may already know, PAs
(Physician Assistants) and NPs have a lot of overlap in job duties, with one major difference
being that to become an NP, one must have first been an RN. Even as a current NP, I still retain
the title of an RN, and subsequently retain certain job duties pertaining to an RN. As only an RN,
my job duties and responsibilities used to entail things such as administering medications,
cleaning patients, assessing and monitoring the condition of patients, carrying out the MD’s
(Medical Doctor) orders, alerting MDs if and when problems arose, conducting tests and also
looking at results. Additionally, as part of my work in the ICU as an RN, my responsibilities that
differentiated me from an average RN would be my role as an RNFA (Registered Nurse First
Assist). I learned to scrub in and assist MDs when needed, which was a great benefit since many
RNs don’t get to experience this. When I became an NP, I left behind duties such as
cleaning/turning patients, but still retain duties such as assessing patients and have expanded
former duties such as carrying out the MD’s orders by now working to write my own orders, and
27

28. make informed plans and decisions. This is not to say that I make these types of decisions
completely independently however, as I still have to work with my supervising MD in unison. I
also adopted new duties in my dual role as an RN/NP in that I work to get patients safely to
surgery, interview and obtain medical history, conduct a review of systems, which is also known
as a current health status, order medications to either stop or start before and after surgery, and
address concerns or work to pull in the correct consults if needed to ensure a safe surgery.
5. What do you enjoy most about this job?
That’s quite the question, but if I had to start somewhere and be completely honest, I’d have to
say working with people and truly making a difference in people’s lives. By working here in
POM (Perioperative Medicine), I frequently see people in a very unsure and insecure time in
their lives, so having the ability to help alleviate any fears or concerns they may have is a great
feeling. I feel that the nursing profession in general has the ability to truly get through to patients
in a way that other branches of the medical field may not always be able to. Nursing has at its
core a warm and nurturing way, and patients are so grateful when I am able to get on their level.
6. What do you enjoy least about this job?
There’s not too much that I dislike about this job, other than the fact that we as NPs are
somewhat stuck in between the roles of RNs and MDs. Similar to PAs, the line can often blur as
we straddle the line sometimes and it can be hard for MDs to accept us in the field, since our
duties overlap quite a bit. In fact, together with PAs we are often referred to as a “Physician
Extended,” since depending on who and where we work for, we can have almost complete
independence to practice, with minimal input from the supervising MD. Here at Kaiser however,
I would more closely identify with the term “Mid-Level Provider,” since I work as an
intermediate between an RN and MD, in the context of RNs carrying out orders and decisions
and an MD making fully independent decisions.
7. What would be your recommendations for graduates like myself who are interested in a
job like this one?
I know that you stated earlier your interest in the PA field, but I urge you to fully look at all of
your options in the medical field before you commit. NPs often overlap in job duties with PAs,
so you may find that the work that I do is something that interests you if you explored it. The
requirements for entry into the medical field can vary vastly between professions, so I urge you
to also take this into consideration and be aware of time commitments involved with programs
and the prerequisites needed, including experience and type of degree.
8. Any career tips you would like to offer me?
I would highly advise shadowing as much as you can. Though most people look at a paid job as
the only way to get experience in the medical field, it’s often overlooked that providers are often
very happy to take students under their wing and you don’t have to have a degree to shadow, just
an interest in the field. In this way, you can more fully explore the medical system and become
very well rounded. Shadowing can also lead to great networking opportunities, which are
invaluable not only in your search for references when applying to schools or programs, but also
in your professional medical career later down the road. Another benefit is that shadowing can be
a great way to get your foot in the door and can lead to entry-level jobs or future connections
when searching for a job. I also realize that this time right now can seem quite stressful, as it can
28

29. seem like a monumental task to land the perfect job after college, or to find the perfect graduate
program. I encourage you to not sweat the little stuff though and focus on just getting your foot
in the door and the rest will all work itself out.
29

30. List of 5 Scientific Journals
Journal of General Internal Medicine
American Journal of Public Health
Military Medicine
The Journal of Bone & Joint Surgery
Journal of General Internal Medicine
30

31. A Glimpse Into the Increasing Prevalence of Post Traumatic Stress Disorder Among
Female Veterans
Cameron Smith
California State University East Bay
Section 02
Winter 2015
31

32. Introduction
Violent crimes and traumatic events are reported quite frequently throughout the news
media in today’s society. Although the events themselves are deemed newsworthy, the aftermath
in terms of survivor’s mental health is often neglected. Rates of disorders such as depression and
Post Traumatic Stress Disorder have soared in recent decades, especially in the wake of current
overseas conflicts, Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF).
Close to 40,000 veterans since 2003 have been officially diagnosed with PTSD, while as many
as 1 in 5 present symptoms. (Facts | Anxiety and Depression Association of America, ADAA)
Rates among the various demographics of veterans fluctuate, although females have been
identified as an increasing concern. According to the United States Department of Veterans
Affairs (VA), prevalence of PTSD in the general population for females is around 10%,
compared to only 4% in males. Emerging research has found that female veterans are
increasingly being diagnosed with PTSD, while many others display symptoms. The actual
number of female veterans however, has been hard to determine since utilization of VA mental
health services is much lower when compared to males. (Washington, Davis, Der-Martirosian &
Yano, 2013) The research conducted in this paper seeks to find a scientific basis for the divide
and explores the current research. The question then becomes, why have female veterans
returning from OEF and OIF been suffering increasing rates of PTSD? This paper implores that
the evolving role of females in combat situations as well as increasing rates of sexual
assault/abuse and a general predisposition in brain chemistry all intermingle.
Method
Research was conducted in both CINAHL and Academic Search Premier by first utilizing
keywords, such as “PTSD”, “veterans”, “mental health”, “veterans affairs”, “trauma,”
32

33. “violence,” “war,” and “readujustment.” Upon conducting research it became apparent that
certain groups were more vulnerable than others in the prevalence of PTSD. An early research
question was, why do some veterans face a higher risk for developing PTSD than others? One
group that seemed to stand out more than the others however was female veterans. Many articles
contained research that had noted female veterans with higher than average rates of PTSD or
symptoms associated with PTSD. At this point, I narrowed my search to studies based on female
veterans and rates of PTSD.
A surprising lack of knowledge about this population led to many speculations, while
some articles simply went off on tangents that did not tie into my main topic. After searching
through numerous articles, I identified the need for studies that had been conducted more
recently, as the most amount of information pertaining to this population would be available. I
then decided that the current overseas conflicts, OEF and OIF were the best place to center my
research, since studies pertaining to them would be the most relevant.
In order to be considered a potential source for the literature review, the source had to
contain information both about female veterans in the current overseas conflicts and any
additional information that might contribute to an explanation as to why the rates were so high.
A common thread became combat exposure, sexual assault and abuse and a general
predisposition in brain chemistry.
Literature Review
In recent years, the amount of women in the U.S. military has steadily been increasing.
According to Maguen, Ren, Jeane, Bosche, Marmar, and Seal, “women…compose 12.65% of
the total number of US military personnel who have served in Operation Enduring Freedom
[OEF; principally in Afghanistan] and Operation Iraqi Freedom [principally in Iraq]). With an
33

34. increase of women in the military comes an increasing veteran population as well. By the time
they have become veterans, many have experienced trauma through combat and even sexual
assault. For this reason, “both depression and PTSD [post-traumatic stress disorder] have been
cited as major problems among female veterans.” (Luxton, Skopp, & Maguen, 2010)
Post-traumatic stress disorder is defined as a “chronic, disabling condition caused by
witnessing or being involved in a horrifying trauma, such as combat or sexual assault. Symptoms
include intrusive, recurrent recollections of the trauma; heightened autonomic reactivity: sleep
disturbances: impaired concentration and memory: and ‘numbing’ symptoms characterized by
anhedonia, restricted emotional affect, social detachment, and isolation.” (Murdoch, Polusny,
Hodges, & O’Brien, 2004)
In the past, “ample research has examined female veterans who served in Vietnam, the
first Gulf War, and female veterans of multiple eras seeking Department of Veterans Affairs
(VA) health care, [however] relatively little has been published on female OEF and OIF
veterans.” (Maguen, Ren, Jeane, Bosche, Marmar, & Seal, 2010) One theory that explores
gender differences states that “women and men vary in their expression of mental health
symptoms, with women more often receiving internalizing diagnoses, such as depression, and
men receiving more externalizing diagnoses, such as alcohol and substance use disorders.”
(Maguen, Ren, Jeane, Bosche, Marmar, & Seal, 2010) With women gaining progressively
expanding roles in the military, the current conflicts overseas provide a great opportunity to
study why rates of PTSD and depression have been soaring.
Throughout most of history, women have played somewhat of a supporting role to men in
terms of military service. “Beginning with the War of Independence (1775-1783)…wives,
mothers, and daughters frequently accompanied male relatives to the battlefield in order to
34

35. perform care taking roles such as cooking, washing clothes, and attending to the wounded.”
(Chaumba & Bride, 2010) As time progressed, women’s roles gradually expanded, especially in
World War II, when “women with special skills, such as female pilots flew military aircraft [and]
…in the 1990’s [when] roles expanded to include flying combat aircraft, serving on ships, and
driving convoys, tasks that may increase exposure to combat trauma.” (Chaumba & Bride, 2010)
When looking at combat exposure, research has found that “women, compared to their male
counterparts, might be at higher risk for PTSD following CE (combat exposure)” (Luxton,
Skopp, Maguen, 2010) Researchers from this study however recognized that there are other
factors that come into play which may contribute to the higher risk for PTSD and depression, and
that potential future research could focus on levels of social support as a predictor. (Luxton,
Skopp, Maguen, 2010)
With the expanding role of women in combat roles, combat trauma has been identified as
one of the strongest predictors for the development of PTSD and depression. (Luxton, Skopp,
Maguen, 2010) Increasing combat exposure has been tied to the fact that “although the
Department of Defense (DOD) does not permit the assignment of female service members to
combat infantry or special operations units at this time, traditional front and rear lines are
nonexistent in the OEF/OIF conflicts. Women on operational deployments to OEF/OIF are
performing regular duties in a combat environment where they are exposed to hostile situations
and military attacks.” (Luxton, Skopp, Maguen, 2010) This increasing exposure has led to “roles
that expose them to potentially traumatic events such as injury, seeing the dead, dying or
wounded.” (Chaumba & Bride, 2010)
Specific demographics have also been identified as predictors for the development of
PTSD and depression as well. One study noted, “Women were more likely to be young, black,
35

36. single, and veterans of the Air Force.” (Maguen, Ren, Jeane, Bosche, Marmar, & Seal, 2010)
The same study noted that age, specifically women over 30 years, was significantly correlated
with a diagnosis of PTSD. An interesting discovery from this study found that men’s rates of
PTSD were quite the opposite, in that younger men were at a greater risk than older men. The
researchers hypothesized that “women who are older may have more established family and
community lives and may have a more difficult time deploying and then reintegrating after
returning from war.” (Maguen, Ren, Jeane, Bosche, Marmar, & Seal, 2010)
A more recent study found that certain other demographics were also correlated with
higher PTSD risk. These demographics included “being uninsured, having an annual household
income below the federal poverty level...fair or poor health status, disability…history of sexual
assault in the military, and positive screening test for depression and anxiety disorder.”
(Washington, Davis, Der-Martirosian, Yano, 2013) In terms of health care, the same study found
that “the vast majority of women veterans screening positive for PTSD received their healthcare
in community settings.” (Washington, Davis, Der-Martirosian, Yano, 2013) This finding
becomes relevant when one considers that “most veteran research is conducted in Veterans
Health Administration (VA) healthcare settings.” (Washington, Davis, Der-Martirosian, Yano,
2013) According to the researchers of this study, this “[leads] to a gap in information about the
vast majority of women veterans for conditions that are associated with military service.”
Treatments are also affected in that “when patients do receive treatment they are more likely to
receive medications than empirically validated psychological treatments. As treatments have
been developed through study of primarily male veterans, the results may not always apply to
female veterans.” (Freedy, Magruder, Mainous, Frueh, Geesey, & Carnemolla, 2010)
Based on the previously cited studies, future research could thus focus on “building
36

37. gender-specific results…to develop gender-sensitive mental health services within the VA and
related military primary care systems. (Freedy, Magruder, Mainous, Frueh, Geesey, &
Carnemolla, 2010) The same researchers also suggested that “in the appropriate clinical setting,
primary care professionals should screen adult patients for the potential presence of traumatic
life events and mental health symptoms…both appropriate psychotropic medications and
empirically validated psychological approaches should be considered.”
Although combat exposure has been a main focus of many PTSD studies, sexual assault
has been found to be a potent predictor for development among women veterans. According to
one study, “rates of sexual harassment range from 24% to 78% among women in the military,
while sexual assault ranges from 3% to 41%” (Chaumba & Bride, 2010) Sexual assault rates
fluctuate so vastly because “reports of sexual assault vary among active-duty, reserve and
veteran females. Whereas reserve and active duty women have reported comparable rates of
sexual trauma 2% and 3% respectively, female veterans reported rates as high as 41%”
(Chaumba & Bride, 2010) The researchers postulated that the lower rates among active duty and
reserve women could be due to underreporting. In line with such high rates of harassment and
assault come even more astounding rates, “women with military sexual assault history were 9
times more likely to have PTSD, while female veterans with childhood sexual assault histories
were 7 times more likely to have PTSD, and those with civilian sexual assault histories were 5
times more likely to have PTSD.” (Chaumba & Bride, 2010) For this reason, it is encouraging
that the VA mandated that “all veterans, regardless of sex, be screened for military sexual
trauma.” (Murdoch, Polusny, Hodges, and O’Brien, 2004) A problem with this directive
however, has been compliance, as many clinicians have tight schedules and do not always abide
by it.
37

38. Results
A common thread among research pertaining to increasing rates of PTSD in the female
military veteran community is the higher prevalence of combat exposure and sexual
assault/abuse than in the past. According to Chaumba & Bride (2010), women with higher levels
of war-zone exposure were 7 times [more] likely to have current PTSD than those with less
exposure…[and] women with military sexual assault history were 9 times more likely to have
PTSD.” In a study conducted by Murdoch, Polusny, Hodges & O’Brien, “30% of females
experienced at least some combat exposure [while the] in service sexual assault [rate stood at]
71%” These rates represent a significant portion of female veterans and provide a meaningful
basis for consideration.
A study conducted by Luxton, Skopp, & Maguen (2010) found that increasing trauma
rates might not quite be the key to the question of increasing rates of PTSD among female
veterans. They found that “women are more likely to meet criteria for PTSD compared to men,
and this vulnerability is not explained by higher risk or more severe traumatic events. Data
therefore suggests that there might be differential risk factors for PTSD based on gender.”
Among the general population for instance, “women are at much higher risk for depression than
men.” (Luxton, Skopp, & Maguen, 2010)
Some studies that support the theory of Luxton, Skopp, & Maguen (2010) have found
that certain demographic groups do correlate with higher rates. Washington, Davis, Martirosian,
& Yano (2013) found that “younger age, being a racial/ethnic minority, being uninsured, having
an annual household income below the federal poverty level, period of military service, fair or
poor health status, disability, and diagnosed depression” all correlated with higher rates. Maguen,
Ren, Bosch, Marmar & Seal (2010) also found age to be a significant factor, along with being
38

39. “divorced, separated, or widowed.”
Discussion
The research conducted gave rise to a clearer picture of why rates of PTSD among female
veterans of the recent OEF and OIF wars have been climbing. Levels of increasing combat
exposure and sexual assault/abuse are in fact potent predictors in the development of PTSD,
however they are not the sole causes.
Upon conducting research, differences in brain chemistry, such as how males and females
process trauma and stress may play a role. Whereas men tend to be more external with their
coping mechanisms, such as drinking or even seeking social support, women tend to internalize
their feelings and are often hesitant to seek help. Both men and women tend to have
misconceptions about mental health, however the research conducted revealed that women are
more often neglected in the healthcare setting and the services available to them are not always
explained. For this reason, utilization of mental health services among female veterans is lower
than for men, as their internalizing problems such as combat trauma and sexual assault/abuse are
not discovered. Rather than preventing these types of problems from spiraling into PTSD, the
diagnosis is made after many women have been left to deal with their issues on their own.
Certain demographics were also found to correlate with a higher risk for developing
PTSD. The most potent predictors among demographics tended to be age and marital status,
although correlations were found among various other groups. Age and marital status may play a
role in the development of PTSD because social support systems may be more difficult to obtain
for those who are single or those who are older. Social support has been shown to be an
extremely effective method in the prevention of PTSD symptoms, as it allows women to
externalize their feelings, rather than dealing with them on their own. Future research on the
39

40. availability of social support systems and the development of PTSD might yield interesting
results in the level of prevention provided.
Conclusion
The role of the female soldier has seen an expansive overhaul in recent times. Exposure
to an increasing level of combat trauma thus compounds problems such as sexual assault and
abuse and creates the perfect storm for development of mental health issues such as PTSD. The
general brain chemistry of females differs from that of males, which thus affects their coping
mechanisms when confronted with stress and trauma. This general difference needs to be taken
into account when sending females into war and the subsequent treatment that they receive when
returning from war. Future research could focus on why utilization rates for VA mental health
facilities are so low among female veterans as well as which types of treatment show the most
potential for prevention and recovery.
References
Chaumba, J., & Bride, B. (2010). Trauma Experiences and Posttraumatic Stress Disorder Among
Women in the United States Military. Social Work in Mental Health, 8(3), 280-303.
Retrieved February 1, 2015, from CINAHL Plus.
Chaumba, J., & Bride, B. (2010). Trauma Experiences and Posttraumatic Stress Disorder Among
Women in the United States Military. Social Work in Mental Health, 8(3), 280-303.
Retrieved March 1, 2015, from Academic Search Complete.
Conard, P., & Sauls, D. (2014). Deployment and PTSD in the Female Combat Veteran: A
Systematic Review. Nursing Forum, 49(1), 1-10. Retrieved March 1, 2015, from
Academic Search Complete.
Facts | Anxiety and Depression Association of America, ADAA. (n.d.). Retrieved February 18,
40

41. 2015, from http://www.adaa.org/living-with-anxiety/military-military-families/facts
Freedy, J., Magruder, K., Mainous, A., Frueh, B., Geesey, M., & Carnemolla, M. (2010). Gender
Differences in Traumatic Event Exposure and Mental Health Among Veteran Primary
Care Patients. Military Medicine, 175(10), 750-758. Retrieved February 1, 2015, from
CINAHL Plus.
Himmelfarb, N., Yaeger, D., & Mintz, J. (2006). Posttraumatic Stress Disorder In Female
Veterans With Military And Civilian Sexual Trauma. Journal of Traumatic Stress, 19(6),
837-846. Retrieved March 1, 2015, from Academic Search Complete.
Luxton, D., Skopp, N., & Maguen, S. (2010). Gender Differences In Depression And PTSD
Symptoms Following Combat Exposure. Depression and Anxiety, (27), 1027-1033.
Retrieved February 1, 2015, from CINAHL Plus.
Maguen, S., Cohen, B., Cohen, G., Madden, E., Bertenthal, D., & Seal, K. (2012). Gender
Differences in Health Service Utilization Among Iraq and Afghanistan Veterans with
Posttraumatic Stress Disorder. Journal Of Women's Health, 21(6), 120222070544008-
120222070544008. Retrieved March 1, 2015, from Academic Search Complete.
Maguen, S., Ren, L., Bosch, J., Marmar, C., & Seal, K. (2010). Gender Differences in Mental
Health Diagnoses Among Iraq and Afghanistan Veterans Enrolled in Veterans Affairs
Health Care. American Journal of Public Health, 100(12). Retrieved February 1, 2015,
from CINAHL Plus.
Murdoch, M., Polusny, M., Hodges, J., & O'Brien, N. (2004). Prevalence of In-Service and Post-
Service Sexual Assault among Combat and Noncombat Veterans Applying for
Department of Veterans Affairs Posttraumatic Stress Disorder Disability Benefits.
Military Medicine, 169(5), 392-394. Retrieved February 1, 2015, from CINAHL Plus.
41

42. Washington, D., Davis, T., Der-Martirosian, C., & Yano, E. (2013). PTSD Risk and Mental
Health Care Engagement in a Multi-War Era Community Sample of Women Veterans.
Journal of General Internal Medicine, 28(7), 894-900. Retrieved February 1, 2015, from
CINAHL Plus.
42

43. Empirical Article Report
1. Reference
Brambring, M. (2007). Divergent Development of Manual Skills in Children Who Are Blind or
Sighted. Journal of Visual Impairment & Blindness, 101(4), 212-225.
2. Abstract
This empirical study compared the average ages at which four children with congenital blindness
acquired 32 fine motor skills with age norms for sighted children. The results indicated that the
children experienced extreme developmental delays in the acquisition of manual skills and a high
degree of variability in developmental delays within and across six categories of fine- motor
skills.
Introduction
3. The general topic that this article investigates is how blindness effects the development of fine
motor skills in children. The skills were divided into 6 categories and comprised 32 individual
tests. The results of the research were compared to children considered to fall within the normal
limits of development.
4. A study conducted in 1997 by Hatton, titled “Development Growth Curves of Preschool
43

44. Children with Vision Impairments,” served as justification for conducting the research conducted
in this article. The study used a standardized development test to assess 186 children with vision
problems, of which 27 were fully blind. They were found to have a mean developmental delay of
13.6 months at 30 months of age. Brambring notes however that the mean age of delay alone,
“provided no information on the variability in the age at which single skills are acquired within
each developmental domain.” (Brambring, 2007, pp. 214) This information he notes, is
necessary in identifying which alternative strategies that children who are blind may use to
“compensate for their difficulties owing to the loss of vision” (Brambring, 2007, pp. 214)
5. Brambring recognized the lack of knowledge pertaining to the acquisition of fine motor skills
in children that are blind and wanted to further explore their realm of development. He was
specifically interested in finding which alternative means of learning various motor skills would
be utilized and when they would typically appear. Also of interest to Brambring was discovering
which fine motor skills would present the greatest barriers to overcome.
Method
6. The 4 participants included in the study were identified as having visual impairments, with 3
being completely blind and the other possessing only “minimal light perception.” (Brambring,
2007, pp. 215) Among the 4 participants, 2 were male and 2 were female and presented no
further impairments than those listed. They were identified as developing normally, based on an
IQ test and teacher input from their schools.
7. A major behavior of interest studied was the age at which visually impaired children acquired
44

45. manual skills. The 4 participants in the study were studied longitudinally during early
intervention home visits. Visits involved participant observation in 32 different manual tasks.
The 32 tasks were then further divided into 6 categories determined by 4 independent raters. The
mean divergences in age for the categories were determined and compared with means from data
compiled through databases pertaining to sighted children. The databases providing data on
sighted children included, “four well-known, standardized developmental tests: Bayley Scales of
Development; Denver Developmental Screening Test; Griffiths Developmental Scales; and
Entwicklungskontrolle fur Krippenkinder, a German language developmental test.” (Brambring,
2007, pp. 215)
Results
8. A significant find from the study found that “manual skills requiring the use of a tool (a
drumstick, cup, or spoon),” showed the largest divergence in development. (Brambring, 2007,
pp. 220) Researchers determined that the visually impaired children acquired these skills an
average of 2.67 times later than their sighted peers did. The results imply that compensatory
measures take longer to develop and thus hinder development when compared to more simple
tasks.
Discussion
9. Brambring was able to conclude that although children that are blind exhibit extreme delays
in many areas when compared to children in the normal range of development, the patterns of
45

46. development occur in roughly the same sequence. These delays were determined to be 14.5
months on average and coincide roughly with earlier research by Hatton indicating 13.6 months.
The development of body-related skills, such as activities of daily living, and simple-object
manipulations that involve “trial and error,” (Brambring, 2007, pp. 222) did not diverge
significantly between the two groups. He surmises that this may be due to the body providing a
reference point for body-related skills and the tactile feedback from trial and error skills
substituting for visual input. Another potential explanation for this could be the relative lack of
visual importance involved in these tasks. He concludes that early compensatory measures
adopted in these areas are more likely than for tasks involving “complex manipulative skills,”
(Brambring, 2007, pp. 222) which require higher cognitive abilities.
Your thoughts on the article
10. Why did you choose this article?
I chose this article due to the fact that I have learned quite a bit about how children normally
develop during this class, but relatively little in terms of how children can deviate. I feel that
going into the medical field after I graduate should mean that I have a good understanding of as
many different types of people and situations as I can. Children that are visually impaired may
not differ in any other ways that other children, and I’m curious to see how they compensate for
their lack of vision.
11. What did you learn from reading this article?
46

47. I learned from reading this article that although visually impaired children are at a disadvantage
when compared to their normally sighted peers, they do follow roughly the same development,
though it is simply delayed. Parents and teachers can thus help visually impaired children by
understanding this and not trying to place the same developmental expectations of normally
sighted children upon them. These children should be allowed more time to explore with tactile
and auditory means to ensure proper development.
12. Do you think the method used was an appropriate way to study the topic? Why or why not?
I think that the method used was inappropriate for this study. In terms of studying such a broad
group of people, the small sample size does not allow any conclusions to be reliably drawn. Any
correlations may have simply been present in this group of individuals only and a more
comprehensive study would be necessary to produce truly meaningful data.
13. Do you agree with the author(s)’ conclusions? Why or why not?
I agree with the author’s conclusions as they seem to coincide with the earlier research that
served as the basis for exploration. They seem to advance the available information available in
the particular field of research and provide an opportunity for future research. The conclusions
seem logical based on the data collected and he does not seem to show any bias in his opinions.
14. Do you think it was a good study? Explain your answer. In answering this question, you
47

48. may want to consider whether the method could be improved, or whether the findings are
important.
I think that the study had its strengths, but that overall it was quite weak. The fact that subjects
were chosen from a pool of 10 children used in a previous study by Brambring suggests that the
results could not be representative of the overall population of visually impaired children, since
they may act differently knowing that they are subjects. A second weakness is the small amount
of children that actually participated in the study. The 4 children studied make it difficult to draw
statistically significant conclusions, especially when considering that children from the sighted
group were actually studied. The information drawn from the sighted group comes from
information drawn from previous studies found through databases. The implications for future
research and the findings do however seem to be relevant to advancement in the field in that they
can help parents and teachers incorporate compensatory measures earlier.
48

49. Exploring Causes for Disparities Among Total Joint Replacement Surgery in African
Americans
Cameron Smith
California State University East Bay
Section 01
Fall 2015
49

50. Exploring Causes for Disparities Among Total Joint Replacement Surgery in African
Americans
Medical technology has advanced at an astonishing rate in the past century, as humans
have enjoyed some of the longest life expectancies in history. Problems that may have in the past
been deemed untreatable or physically and emotionally debilitating can now be successfully
treated. One such problem is Osteoarthritis, which continues to be one of the most common joint
disorders in the United States, especially in women and the elderly, plaguing roughly 13.9% of
adults aged 25 and up, and totaling around 26.5 million people as of 2005 (Lawrence, Felson,
Helmick, Arnold, Choi, Deyo…Wolfe, 2008). In all Characterized by a progressive loss of
articular cartilage and frequent pain, those afflicted often seek an effective treatment option that
can alleviate symptoms as necessary. In the early stages, physicians begin with noninvasive, and
relatively simple treatment options, such as medications to reduce inflammation, physical
therapy, and exercise. As symptoms worsen or when treatments prove ineffective, however, a
replacement of the entire knee joint, commonly called a Total Knee Replacement (TKR) or
Arthroplasty, is recommended. For those with osteoarthritis of the hip joint, a similar procedure,
called a Total Hip Replacement, is performed. Collectively, the procedures in their similarities
are often referred to as Total Joint Replacements (TJR). Although healing occurs quite quickly,
and symptoms can of osteoarthritis can subside almost completely, physicians can be hesitant to
recommend the surgery. Various reasons for this trend may exist, but statistics do show that
disparities occur both in the recommendations and utilization of the surgery, primarily in African
Americans, according to Figaro, Russo and Alegrante (2004).
Current internship duties at Kaiser Permanente in San Leandro, California have allowed
for careful observation in how these disparities occur in the general community. Duties in the
50

51. Perioperative Medicine (POM) department have provided many encounters with patients who
have either received or are in the process of receiving a recommendation for TJR, since the
department is responsible for clearing patients for surgeries. Observation has allowed for close
scrutiny of patient-physician interaction, with the vast number of cultures and ethnicities
encountered providing firsthand experience with the aforementioned trend. Physicians are
responsible for informing patients of the risks and benefits involved with the surgery, and are
also responsible for taking cultural belief systems into consideration when making
recommendations. Since cultures and ethnicities vary in beliefs pertaining to healthcare, the
responsibility of finding a middle ground to ensure patient satisfaction and a return to
comfortable health falls upon the physician. Real-world situations do not always allow for such
compromise to be reached; disparities, therefore continue to thrive, due to a lack of
understanding and knowledge of the procedure, patient preference for alternative forms of
treatment, and physician’s role in educating individuals and recommending the procedure.
Method
I conducted research through CINAHL, Academic Search Premier, PubMed, and
PsycINFO, by first utilizing keywords, such as “TJR”, “ethnic disparities”, “racial disparities”,
“TJR utilization,” and “TJR recommendations.” A surprising lack of research pertaining to the
topic of interest led to the decision to continue research, as it allowed for new areas of
exploration and offered the opportunity to piece together existing research to draw new
conclusions. After searching through various articles, relevant articles were identified based on
how in depth they explored disparities. If substantial portions of the article delved into disparities
and explored knowledge that other articles had not, they were chosen for inclusion. Basic
information regarding TJR was also deemed necessary so that a full picture of the situation could
51

52. be analyzed. Sources were also filtered to include only full-text articles, which were scholarly or
pier-reviewed, and published within the last 15 years.
Discussion
Patient preference is considered a significant deciding factor in whether or not patients
undergo a TJR. According to Ibrahim, the surgery is considered an elective procedure due to the
fact that it is not regularly performed in an urgent setting, and that clinical needs are not the sole
deciding factor (2013). In other words, it is necessary that the patients elect for the procedure in
order for the recommendation to be made. For this reason, many physicians tend to place the
burden of recommendation on the patient, and if they neglect to ask, the recommendation will
not be considered. According to Figaro, et al., patients only tend to prefer the surgery when they
expect pain relief, restoration of regular walking ability, and a higher sense of well-being (2004).
Many African Americans, however, are weary of the outcomes from Western Medicine, so they
often prefer to utilize alternative forms of healing. A study by Figaro et al., discovered that
natural remedies and a belief in God’s control are preferred by many and thus influence their
preference for surgery (2004). Many African Americans within the study stated that they
believed Osteoarthritis was caused by cold or dampness from their environment interacting with
their joints. Belief that Osteoarthritis was an inevitability of aging and that herbs, creams, and
other folk remedies could alleviate, if not, eradicate the disease was also found to be prevalent.
The control of God was also cited as a potential remedy, as many believed that the disease would
simply take an intended course - if they were meant to be healed, it would occur when God
willed it to happen.
Beliefs in divine intervention and natural remedies and how they intermingle with the
recommendation and subsequent decision to undergo surgery can be attributed to differences in
52

53. culture. Disparities exist due to the fact that many African Americans often misunderstand TJR
and thus neglect to opt for it. According to Figaro et al, many African Americans believe that
TJR would lead to a need for replacement within a short timeframe (2004). Also held is the
belief that surgery should be a last resort and that the surgeon may not possess the competency to
correctly perform surgery. When faced with these beliefs, many physicians do not take the time
to address them or rationalize with patients, so recommendation rates remain low. Many African
Americans are also fearful of the surgery itself and believe that complications from the surgery
are cause for concern, so the chances of their condition worsening increase.
In addition to varying cultural beliefs regarding healthcare, patient geographical location
has also been found to play a role in the observed rate disparity. As identified in a study
conducted by Hawker, Wright, Coyte, Williams, Harvey, Glazier, . . .and Badle, there exists a
gap between potential need as identified by physicians, and actual need, as identified by patients,
which widens in certain areas of the country (2001). In areas where potential need was higher,
patient utilization of TJR was higher, suggesting that actual patient need was not as influential in
the decision making process. This also suggests that in areas with identified higher potential
need, problems with overutilization may be occurring, while areas with lower potential need may
be suffering from suboptimal care. (Hawker et al., 2001) Areas with higher potential need were
found to be more populous with non African Americans, while areas with lower potential need
were often found to be areas with higher populations of African Americans. Interestingly,
Hawker also found that willingness to undergo surgery was unrelated to disease severity,
suggesting that external factors such as living circumstances, employment status, age, and social
support systems may also play a role in the disparity. (2001)
When discrepancies arise between patient beliefs, physician knowledge, and the level of
53

54. care afforded to certain geographical areas, the problem of integrating all factors into an
appropriate care plan arises. Due to the fact that TJR recommendation is treated as a team
decision between physician and patient, the recommendation cannot be made when the patient
does not desire the surgery. The role of the physician then becomes educating the patient to the
best of their knowledge in an effort to convince them of the efficacy of treatment. Patients
continue to hold their views and beliefs until the physician successfully integrates them with
those of Western Medicine, which can be quite tough due to the vast differences between them.
The responsibility of successfully improving disparity rates then relies upon the openness of both
patient and physician to the ideas of one another. The typical breakdown in communication that
instead occurs, can further fuel miscommunications, as the absence of a recommendation for
surgery can lead to the inference that it must be a last resort, and therefore quite dangerous.
Interestingly, Hausmann, Mor, Hanusa, Zickmund, Cohen, Grant…and Ibrahim found that when
physicians actually spoke to African American patients regarding beliefs they held and attempted
to clarify the goals o Western Medicine, rates for TJR utilization went up, indicating the
invaluable role physicians play. (2010)
When observing the trend of higher Osteoarthritis rates in women and the elderly, an
interesting trend begins to emerge that seems to conflict with observed racial disparities.
According to a study conducted by Dunlop, Manheim, Song, Sohn, Feinglass, Chang H., and
Chang, R., disparity rates between African Americans and Caucasians in the utilization of TJR
become almost indistinguishable in those under the age of 65. (2008) The findings may be due to
higher preference for more minor interventions in the treatment of Osteoarthritis in those who are
younger, such as Arthroscopy or drug treatments. Dunlop et al, hypothesizes that the discrepancy
between younger and older African Americans may also be related to general mistrust of
54

55. physicians in older patients, due to the Tuskegee experiments conducted by the United States
government, as well as ideals carried from times of segregation. Additionally, higher rates of
college education among younger patients may lead to more informed patients that are open to
TJR. (2008)
Conclusion
Disparities among TJR surgeries occur when belief and value systems differ between
physicians and patients, and communication to integrate those held by both parties cannot be
made. African American beliefs can be integrated with those held by physicians through working
with the assessment of natural remedies being utilized, and seeing if and how they may impact
the outcome of surgery. If conflicts are found, patients can briefly stop use or adjust amounts
used to accommodate a safe surgery. Physicians can dispel any misconceptions or fears when
they are able to take the time to understand what cultural differences may exist and address them
rather than assuming patients will always inquire about them. Future research in the area of TJR
disparities can look at ways that physicians are actively working to help patients receive the best
possible outcome from their Osteoarthritis and if they are taking time to understand cultural
differences. Additionally, further research can look into why disparities are much less prevalent
in younger patients as opposed to those over the age of 65.
55

56. References
Dunlop, D., Manheim, L., Song, J., Sohn, M., Feinglass, J., Chang, H., & Chang, R. (2008). Age
and Racial/Ethnic Disparities in Arthritis-Related Hip and Knee Surgeries. Medical Care,
46(2), 200-208. Retrieved November 15, 2015, from PubMed.
Figaro, M., Russo, P., & Allegrante, J. (2004). Preferences for Arthritis Care Among Urban
African Americans: "I Don't Want to Be Cut". Health Psychology, 23(3), 324-329.
Retrieved November 15, 2015, from CINAHL Plus.
Hanchate, A., Zhang, Y., Felson, D., & Ash, A. (2008). Exploring the Determinants of Racial
and Ethnic Disparities in Total Knee Arthroplasty. Medical Care, 46(5), 481-488.
Retrieved November 15, 2015, from PubMed.
Hausmann, L., Mor, M., Hanusa, B., Zickmund, S., Cohen, P., Grant, R., . . . Ibrahim, S. (2010).
The Effect of Patient Race on Total Joint Replacement Recommendations and Utilization
in the Orthopedic Setting. J GEN INTERN MED Journal of General Internal Medicine,
25(9), 982-988. Retrieved November 15, 2015, from Academic Search Complete.
Hawker, G., Wright, J., Coyte, P., Williams, J., Harvey, B., Glazier, R., . . . Badley, E. (2001).
Determining the Need for Hip and Knee Arthroplasty: The Role of Clinical Severity and
Patient Preferences. Medical Care, 39(3), 206-216. Retrieved November 15, 2015, from
PubMed.
Ibrahim, S. (2010). Racial variations in the use of knee and hip joint replacement: An
introduction and review of the most recent literature. Current Orthopaedic Practice, 21(2),
126-131. Retrieved November 15, 2015, from Academic Search Complete.
Ibrahim, S., & Franklin, P. (2013). Race and Elective Joint Replacement: Where a Disparity
Meets Patient Preference. Am J Public Health American Journal of Public Health, 103(4),
56

57. 583-584. Retrieved November 15, 2015, from PsycINFO.
Kremers, H., Larson, D., Crowson, C., Kremers, W., Washington, R., Steiner, C., . . . Berry, D.
(2015). Prevalence of Total Hip and Knee Replacement in the United States. The Journal
of Bone & Joint Surgery, 97(17), 1386-1397. Retrieved November 15, 2015, from
Academic Search Complete.
Lawrence, R., Felson, D., Helmick, C., Arnold, L., Choi, H., Deyo, R., . . . Wolfe, F. (2008).
Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United
States: Part II. Arthritis Rheum Arthritis & Rheumatism, 58(1), 26-35. Retrieved
December 5, 2015, from CINAHL Plus.
Logan, C. (2014). Total Joint Replacement: Knee and Hip. IDEA Fitness Journal, 11(10), 40-49.
Retrieved November 15, 2015, from Academic Search Complete.
57

58. Neuro Exercise Therapist
SCI-FIT - Pleasanton, CA
$20 - $27 an hour
SCI-FIT is Northern California's only progressive, post-traditional exercise therapy facility for spinal cord
injuries and neurological disorders. Located in Pleasanton, the mission of SCI-FIT is to maximize
the potential for each individual suffering from a debilitating injury or disorder by utilizing
strategic exercises and providing the proper stimulation for an optimal functional outcome.
At SCI-FIT, we have the unique opportunity to work with clients one-on-one in a thriving, energetic
atmosphere. Our clients work extremely hard and we expect our staff to work even harder to help
them reach their potential in recovery. We are looking for new trainers to add to our talented and
energetic staff. We are seeking dynamic, enthusiastic, energetic coaches and trainers who have a
passion for inspiring health and progress in others. Working with this special population is not
only extremely rewarding, but the field of neuro recovery is constantly evolving, which presents
trainers with exciting new challenges and educational opportunities.
Employment Specifics:
• Job title: Neuro Exercise Therapist
• Part time with opportunity for full time after training period.
• Salary: $20-$27 with potential for increase. Based on experience.
• Health Insurance stipend after probation period and full time status
• 12 paid time of per year after probation period and full time status
• Starting date flexible, but as soon as possible is ideal.
• Hours of operation Monday-Saturday approximately 9-5pm. Applicants schedule will be decided
upon once hired starting with a few days a week. Applicant must be available Mondays and
Saturdays to work.
Minimum Requirements:
58

59. • Bachelor's degree preferably in Kinesiology/Health/Exercise science or related field.
• Previous experience in a health-related or fitness field, personal training and or sports/strength
and conditioning at least 1 year.
• Strong passion for and commitment to your own personal health.
Desired Requirements:
• Certifications (CSCS, NASM, ACE, ACSM) a plus but not a requirement.
• Current CPR/AED certification (can be obtained within first 4 weeks of employment).
Desired Traits:
• Team player
• Strong work ethic, willingness to learn, a passion for helping people and the initiative to go above
and beyond what is expected.
• Charismatic, out-going, detail oriented, reliable, passionate, and enthusiastic.
Experience working with special populations is not necessary and the right individual will be given the
tools needed to succeed in this position by our experienced staff. Like most training positions, the
job is very physically demanding- good physical condition is a must.
Visit our website www.sci-fit.org for more information on our company and the program we offer. Also,
check our YouTube channel (Sci Fit Ca) to see examples of our clients and trainers at work.
Required education:
• Bachelors
59

60. November 29, 2015
22546 Main Street, #8
Hayward, CA 94541
(510) 512-2898
csmith93@horizon.csueastbay.edu
To Whom It May Concern:
I am writing to convey my interest in the Neuro Exercise Therapist position. I am graduating
from Cal State East Bay in December of this year, with my Bachelor of Science in Health
Science. I am also certified as a Nursing Assistant and have since adopted a high level of
enthusiasm in improving morale in life altering patient circumstances. I plan on applying to
graduate school within the next two years and would love to gain not only experience but also
effectively contribute to improving the lives of others.
I became highly motivated in working for Sci Fit after learning of your company’s commitment
to improving the lives of clients in such an innovative way. I am well aware that when
debilitating injuries occur, the hospital setting can severely hamper morale to recover and ability
to return to a fulfilling daily life. I believe that the approach of Sci Fit in helping patients work
past these circumstances helps provide a sense of accomplishment and overall well being. I
believe that my knowledge and nurturing personality along with my passion for exercise and
fitness provide a winning combination for your company and client base.
I would thoroughly love the pleasure of meeting with you to learn more about the position or any
other positions you may have available. I would be glad to provide you with any other
information upon request.
Thank you for taking time out of your busy schedule to review my offer, and I look forward to
meeting with you soon.
Sincerely,
Cameron C. Smith
60

61. Cameron Smith
22546 Main Street, #8 Hayward, CA 94541
(510) 512-2898
csmith93@horizon.csueastbay.edu
Objective
To effectively combine my medical knowledge and nurturing, energetic personality in a manner that
raises client morale and contributes to an optimal functional outcome.
Employment History
NATIONAL/ALAMO RENT-A-CAR– San Francisco, CA
Mail Courier/Driver, December 2010 - Present
• Responsible for traveling to other branches and maintaining the efficient delivery of inter-office mail
and supplies to the correct locations.
• Maintaining relationships with managers at each branch and ensuring important documents are received
by main office.
• Competing inventory for all lots in South San Francisco area.
• Maintaining a constant organization of vehicles and ensuring their availability to customers.
• Working with foreign customers and teaching various features of vehicles, and providing superior
customer service.
INSTITUTE ON AGING– San Francisco, CA
Certified Nursing Assistant, November 2014 - March 2015
• Performed activities of daily living (ADL's)
• Helped transfer and move residents
• Helped promote resident independence when opportunities were present
• Groomed and bathed residents
• Assisted with feeding and dressing residents
Education
EDEN AREA ROP – Hayward, CA
Clinical Medical Assisting Program, CMA Certificate, September 2015-Present
KAISER PERMANENTE – San Leandro, CA

62. Student Intern, Perioperative Medicine (POM), September 2015-December 2015
CALIFORNIA STATE UNIVERSITY EAST BAY – Hayward, CA
Health Sciences BS Major, September 2011 – December 2015
NCP CAREER COLLEGE – Hayward, CA
Certificate of Completion in Certified Nursing Assistant Program, July 2014-September 2014
ARROYO HIGH SCHOOL – San Lorenzo, CA
Diploma, Graduated June, 2009
Organizations
• Active member of the Delta Chi Fraternity, Hayward, CA Chapter
• Associate member of the American Academy of Physician Assistants
62

63. Personal Essay
I began my studies at Cal State East Bay in 2011 and quickly decided that Health Science
would be a great major to apply my passion and expand interest in the medical field by exploring
the various health careers. I immediately felt at home as I thoroughly enjoyed learning about the
intricate nature of the human body and its functions and how the various medical careers
cooperate to promote health and wellness. I decided to pursue the path of Physician Assistant
after conducting some research for a general studies class and then stumbling upon a conference
for aspiring Physician Assistants. Upon attendance, I fell in love with the profession as the
majority of Physician Assistants I met seemed incredibly happy with life and where their careers
had taken them. Thinking upon my own propensity for helping others and my knack for medical
knowledge, I knew it was the right path for me and have been pursuing it ever since, through
shadowing Physician Assistants and other medical professionals they interact with, completing
an internship with Kaiser Permanente, and researching graduate programs and timelines.
I feel that the first logical step after leaving Cal State East Bay is to utilize my Bachelor’s
degree by obtaining a position within the medical field that allows me to thrive and fully assert
my passion for helping others. I know that I am ready to practice and further build upon the skills
that I have learned thus far in my college career by combining them with my charismatic,
innovative, and optimistic attitude to successfully contribute to a team. My place in the medical
field needs to begin with an environment in which practical knowledge and problem solving are
both valued and able to be honed in those willing to work for them.
63

64. Reference:
(n.d.). Retrieved December 6, 2015, from
http://www4.kimmelcancercenter.org/kcc/kccnew/about/org-chart-10-03-07_800x600.jpg
64