Moral injury affects a variety of populations who make ethically complex decisions involving their own and others' well-being, including combat veterans, healthcare workers, and first responders. Yet little is known about occupational differences in the prevalence of morally injurious exposures and outcomes in nationally representative samples of such populations.

In a recent study led by NCIRE-supported Principal Investigator, Dr. Shira Maguen, researchers examine the prevalence of potentially morally injurious event (PMIE) exposure and clinically meaningful moral injury in three high-risk groups.

A recent study of NCIRE-supported Principal Investigator, Dr. Mehrdad Arjomandi, was cited in the Annals of the American Thoracic Society in an editorial titled “Lung Volumes in Smokers without COPD – A Pointer to Disease Development?”

The article cited Dr. Arjomandi’s November 2024 study titled “Phenotypes and Trajectories of Tobacco-exposed Persons with Preserved Spirometry: Insights from Lung Volumes”.

Read the editorial here: https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202502-146ED

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Read the study here: https://pubmed.ncbi.nlm.nih.gov/39586032/

NCIRE-supported Principal Investigators, Drs. Theresa Allison, Deborah Barnes, Kenneth Covinsky, and Alexander K. Smith, co-published a study in the Journal of Applied Gerontology concerning the lived experiences of spouses and partners providing dementia care at home.

The article, titled “I Aim to Fulfill My Promise”: Dementia Caregiving from the Perspective of Spouses and Partners “, explores the challenges and bright spots of dementia caregiving within relationships of up to 60 years.

NCIRE-supported Principal Investigator, Dr. Rebecca Sudore, is collaborating with the San Francisco Palliative Care Work Group on a 2024-2025 PCORI Dissemination Award. The project aims to empower the city’s Latinx Community members to engage in high-quality advance care planning, aligning healthcare with their wishes and values and reducing the decision-making burden on families and caregivers. This goal will be achieved by developing, implementing, evaluating, and disseminating a culturally tailored train-the-trainer program. Catholic Charities, Centro Latino de San Francisco, Family Caregiver Alliance, the Latino Task Force, Mission Neighborhood Centers, Mission YMCA, On Lok 30th Street Senior Center, and San Francisco In-Home Supportive Services (IHSS) Public Authority will be critical partners for this work.

Congratulations to NCIRE-supported Principal Investigator, Dr. Sei Lee, who was recently selected as one of three inaugural recipients of the San Francisco Campus for Jewish Living (SFCJL) Research Scholars program. As part of this program, Dr. Lee will be the Interim Director for Research at the SFCJL, working to enhance research opportunities at the organization, formerly known as "The Jewish Home".

On January 7, 2025, NCIRE-supported cardiology Principal Investigator, Dr. Joseph Yang, performed the first ever percutaneous coronary intervention in the Northern California VA Health Care System at the Mather VA Hospital, in conjunction with the cardiac catheterization laboratory team led by Drs. Amogh Bhat and Marty Denny.

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Dr. Yang and his fellow NCIRE-supported colleague, Dr. Jeffrey Zimmet, from San Francisco VA have been collaborating with the cardiac catheterization team at Mather VA to further expand care for veterans in the region. Additionally, by strengthening the clinical collaboration with their colleagues in the Northern California VAHCS, the ongoing research efforts will be further expanded with enrollment in clinical trials at SFVA.

Congratulations to NCIRE-supported Principal Investigator, Dr. Alexander K. Smith, for receiving the Award for Excellence in Scientific Research in Palliative Care at the Annual Assembly of Hospice and Palliative Medicine in Denver, on Saturday February 8th.  Dr. Smith regaled the audience with a song during his acceptance speech, which you can view online here: https://www.youtube.com/watch?v=BF2KxAzjxK8

Congratulations to NCIRE-supported Principal Investigator, Dr. Duygu Tosun-Turgut, for her induction into the 2025 Class of the American Institute for Medical and Biological Engineering (AIMBE) College of Fellows at its induction ceremony on March 31st!

Election to the AIMBE College of Fellows is among the highest professional distinctions granted to medical and biological engineers, comprised of the top two percent of engineers in these fields. College membership honors those who have made outstanding contributions to "engineering and medicine research, practice, or education” and to "the pioneering of new and developing fields of technology, making major advancements in traditional fields of medical and biological engineering or developing/implementing innovative approaches to bioengineering education."

Dr. Karen Seal is the Chief of Integrative Health and serves as the Medical Director of the Integrated Pain Team (IPT), an interdisciplinary clinic model first established at the San Francisco VA Health Care System (SFVAHCS) for Veterans with chronic pain and opioid dependence.

NCIRE-supported Principal Investigator and Board Member, Dr. Karen Seal is the senior author of the article in JAMA titled, “Care Models to Improve Pain and Reduce Opioids Among Patients Prescribed Long-Term Opioid Therapy: The VOICE Randomized Clinical Trial”. In the VOICE trial—among 820 veterans at 10 VA sites across the country—the SFVAHCS IPT model consisting of a medical provider with expertise in pain management, a pain pharmacist, and pain psychologist was equally effective as another care model (Pharmacist Collaborative Management) in reducing pain and opioid dosage in Veterans. The SFVAHCS IPT clinic is staffed by Elizabeth Gregg, NP (Clinical Director); Kim Banks, NP; Donovan Jenkins, NP; Erin Watson, PsyD; Payal Mapara, PsyD; Cecelia Bess, PhD; Emily Yao, Pharm D; and Nisha Iyer, Pharm D. Other VOICE IPT clinicians were Christina Tat, Pharm D; Sara Librodo, Pharm D; Elizabeth Son, Pharm D; and Caitlin Garvey, NP.

The article was also co-authored by NCIRE-supported Principal Investigators Drs. Jennifer Manual, Brian Borsari, Natalie Purcell, and Ellen Herbst.

NCIRE-supported Principal Investigators Drs. Natalie Purcell, Shira Maguen, Jennifer Manuel, and Board Member Dr. Karen Seal co-published the following articles concerning the impact of COVID-19 on the relationships between health care workers, their patients, and their workplace.:

“When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare” (Purcell, Seal, Maguen) https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02665-1

“Moral injury and mental health in healthcare workers are linked to organizational culture and modifiable workplace conditions: Results of a national, mixed-methods study conducted at Veterans Affairs (VA) medical centers during the COVID-19 pandemic” (Purcell, Seal, Manuel) https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000085

NCIRE-supported Principal Investigator, Dr. Alexander K. Smith, co-published "By the Time We Knew …”: Poetic Analysis of End-of-Life Caregiving Experiences for Rapidly Progressive and Slower-Duration Dementia Syndromes in the Journal of the American Geriatric Society (JAGS).

This secondary qualitative analysis compares end-of-life experiences for caregivers of decedents with different dementia subtypes. It includes 10 poems whittled from interview transcripts and a new conceptual model of dementia end-of-life experience. The interdisciplinary team includes former MSTAR students, postdocs, GBHI Atlantic Fellows, and faculty colleagues across UCSF and the U.S.

NCIRE Board Member, Dr. Louise C. Walter, and her fellow NCIRE-supported investigators, Drs. John Boscardin, Sei J. Lee, Kenneth E. Covinsky, and Alexander K. Smith join a research team to investigate whether the Walter Index predicts posthospitalization mortality in older adults outside the U.S.

The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear. The research team evaluates the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.

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Deception is a universal human behavior. Yet longstanding skepticism about the validity of measures used to characterize the biological mechanisms underlying deceptive behavior has relegated such studies to the scientific periphery.

NCIRE-supported Principal Investigator, Dr. Andrew Kayser, and his colleagues dive into the fringe by applying machine learning methods and functional magnetic resonance imaging (fMRI) to measure human deception.

In 2024, NCIRE-supported Principal Investigator, Dr. Judith Ford, had the bittersweet honor to fulfil the role of Dr.  Herbert Pardes, founding president of Brain & Behavior Research Foundation’s (BBRF) Scientific Council, after his passing in April of last year. With the esteemed support of the BBRF Board, Dr. Ford was selected to lead her council colleagues into its new chapter.

The Winter 2025 issue of BBRF’s magazine Brain & Behavior introduces the new BBRF Scientific Council President, Dr. Judith Ford, in its BBRF Leadership story here: https://bbrfoundation.org/sites/default/files/bb-magazine-february-2025_0.pdf

The Northern California Institute for Research and Education, Inc. (NCIRE) is excited to welcome new Board members, Drs. Salomeh Keyhani and Karen Seal, to its Board of Directors!

Dr. Salomeh Keyhani is a Professor of Medicine at the University of California, San Francisco (UCSF), and Staff Physician and Investigator at the San Francisco VA Health Care System (SFVAHCS). She is also the Director of the Center for Data to Discovery and Delivery Innovation (3DI), a VA-funded Center of Innovation focused on improving health and health care delivery.

Dr. Karen Seal is the Service Chief of Integrative Health at SFVAHCS, and Professor of Medicine and Psychiatry in Residence at UCSF. She serves in leadership roles with the 3DI Center for Innovation and NCIRE’s Women Veterans Research Collaborative, through which she is mentoring the next generation of health services researchers.

The Northern California Institute for Research and Education, Inc. (NCIRE) is excited to endorse our supported Principal Investigators (PIs), Drs. Karen Seal and Carolyn Gibson, in their creation of the Women Veterans Research Collaborative!

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The Women Veterans Research Collaborative (WVRC) is a women-led team of health services clinician researchers and project management staff focused on advancing comprehensive, trauma-informed health care for women Veterans. WVRC specializes in priority areas for women Veterans like chronic pain, PTSD, opioid dependence, menopause-related health, sleep disorders, and complementary and integrative health interventions, spearheaded by WVRC’s nationally recognized experts.