Medicine and Health Sciences Commons^™

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Alumni Journal - Volume 87, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
12 | Of Checks and Recyclables
14 | Interview: Mission Trip Man, Arnold L. Petersen ’66
18 | Graduation 2016
32 | The Physician's Ode
33 | Runaway Patient
34 | Not for the Faint of Heart
36 | I'm Sorry, Not Guilty

Departments
2 | From the Editor
3 | This and That
4 | From the President
6 | From the Dean
7 | The Student Fund
8 | School of Medicine News
40 | AIMS Report
44 | Book Review
46 | Placement and Classified Ads
48 | Alumni News
49 | In Memoriam
52 | …

Today - November / December 2016, Loma Linda University Health

TODAY

Inside this issue:

-- LLU Children's Hospital to open pediatric specialty clinic in Indio
-- Wil Alexander remembered: A trailblazer in whole person care
-- Surgical Hospital earns prestigious national award for excellence
-- School of Medicine receives top national ranking for graduates entering family medicine residencies
-- Community event focuses on healing
-- ‘San Bernardino Strong’ kicks off third season of ‘Life on the Line’
-- Allied Health students learn true meaning of service-learning
-- Law enforcement visits campus for a good cause
-- A heartfelt return to Loma Linda Former
-- Regional economist says Loma Linda University Health …

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …

Registration And Familial Consent For Deceased Organ Donation Among Ethnic Minorities In Ontario, Canada: Opportunities For Improvement, Alvin Li

Electronic Thesis and Dissertation Repository

Canadians on the transplant waiting list are dying every day because there are not enough available solid organs for transplantation. An important aspect of addressing this problem is to increase deceased organ donation consent rates. Consent rates are, in part, affected by the number of adults registering their commitment to deceased organ donation in the event of their death through a donor registry. In provinces such as Ontario, approximately 30% of the population is registered for deceased organ donation and approximately 60% of families consent to organ donation. These low figures have been attributed, without evidence, to the relatively high …

Assets And Barriers To Osteoarthritis, Allison K. Wiles

Scholars Week

Osteoarthritis has remained a prevailing health concern in our society for many years. OA is most commonly seen in middle aged men and women suffering from pain and stiffness in the hip, knee, and thumb areas. Risk factors for OA include age, obesity, previous joint injuries, overuse of joint areas, and weak muscles. If not treated, OA could lead to permanent discomfort and pain, and potentially develop into depression, lowered quality of life, or a need for long-term home health care.

By providing photo footage of every day health care issues, Photo voice persuades community members to change habits and …

Fitness-To-Drive Screening Measure© : Constructing And Validating The Short Form, Shabnam Medhizadah

Electronic Thesis and Dissertation Repository

The valid and reliable Fitness-to-Drive Screening Measure^© (FTDS) is a free online proxy measure that screens for at-risk older drivers using 54 driving-related items. This secondary data analysis aims to construct and validate a short form FTDS, using 200 caregiver FTDS response sets and 200 older driver on-road assessment pass/fail outcomes. To construct the short form, exploratory factor analysis and classical test theory techniques were employed to determine the most interpretable factor model and the minimum number of items that might be used to predict fitness to drive. Next, receiver operating characteristics curves were generated to evaluate the concurrent …

Does Age Influence Dynamic Stability And Muscular Power Following Neuromuscular Fatigue In Women?, Ben J. Hoffmann

Masters Theses

Older adults, especially older women, produce less muscular power than young adults, due primarily to slower maximal contractile velocity. These decrements may lead to increased fall risk in older women and can be exacerbated by fatigue. Recently, a 32 min walking task (32MWT) was shown to elicit fatigue in older women. The purpose of this study was to determine whether knee extensor (KE) maximal velocity is related to dynamic stability (margin of stability, MoS) in young and older women pre- and post-32MWT. METHODS: Nine young (Y; 24.3+1.1years, mean±SE) and 17 older (O; 71.1±1.1years) healthy women completed 2 testing sessions on …

Synthesis, Characterization, And Application Of Monosized Mesoporous Silica Nanoparticle-Supported Lipid Bilayers For Targeted Therapeutic Delivery To Individual Cells, Paul Durfee

Biomedical Engineering ETDs

Mesoporous silica nanoparticle (MSNP) supported-lipid bilayers, termed ‘protocells,’ represent a potentially transformative class of therapeutic and theranostic delivery vehicles. The field of targeted drug delivery poses considerable challenges that cannot be addressed with a single ‘magic bullet’. Consequently, the protocell has been designed as a modular platform composed of interchangeable biocompatible components. The mesoporous silica core can have variable size and shape to direct biodistribution and controlled pore size and surface chemistry to accommodate diverse cargos. The encapsulating supported lipid bilayer can be modified with targeting and trafficking ligands as well as polyethylene glycol (PEG) to effect selective binding, endosomal …

Decisions, Decisions: Factors That Influence A Patient's Medical Tourism Choices, Louis K. Falk, Thomas J. Prinsen

Communication Faculty Publications and Presentations

In the digital age, the amount of information and sources concerning Medical Tourism is overwhelming. Knowledge is power in an era of healthcare uncertainty. As health care options have grown in global proportions, it has become more difficult for potential patients to locate the material necessary to make informed decisions or to even know which factors to consider during their information search. Individual financial circumstances vary greatly. This paper suggests how medical tourism makes financial sense for many patients and payers. Proximity and culture play roles in that medical tourists may prefer locations that are not too far from home. …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Bad Hair Days And The Good Of Pamela Bone's Literary Journalism, Carolyn Rickett

Carolyn Rickett

“I can’t die! I haven’t finished saving the world yet!” (Bone, 2007c, p. 206).

As a recipient of the United Nations media peace prize, Pamela Bone was noted for her fearless reporting on humanitarian, gender and social justice issues. While some of her thought-provoking columns invited controversy, Michael Gawenda notes, “even when people disagreed with her, they respected and understood what she wrote came from her heart and mind and her great moral clarity” (quoted in Chandler, 2008, n.p.).

Retiring from The Age at the end of 2005, Bone accepted an invitation from Melbourne University Press to write a memoir …

The Complete Health Improvement Program (Chip), Darren Morton

Darren Morton

Over 2,000 years ago Hippocrates asserted: "Food and exercise... work together to produce health". Evidence for the wisdom of this Hippocratic council emerged throughout the 20th Century as large epidemiological studies, including the Framingham Heart Study, Nurses Health Study, EPIC (European Prospective Investigation into Cancer and Nutrition) and the Adventist Health Study, highlighted the relationship between lifestyle and disease.

Gender Differences In Effectiveness Of The Complete Health Improvement Program, Lillian Kent, Darren Morton, Paul Rankin, John Gobble, Hans A. Diehl

Darren Morton

Objective: To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program.

Design: Thirty-day cohort study.

Setting: One hundred thirty-six venues around North America, 2006 to 2009.

Participants: A total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0 ± 12.9 years).

Intervention: Diet, exercise, and stress management.

Main Outcome Measures: Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG).

Analysis: The researchers used t test and McNemar chi-square test of proportions, at P < .05.

Results: Reductions were significantly greater …

Gender Differences In Effectiveness Of The Complete Health Improvement Program, Lillian Kent, Darren Morton, Paul Rankin, John Gobble, Hans A. Diehl

Lillian Kent

Objective: To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program.

Design: Thirty-day cohort study.

Setting: One hundred thirty-six venues around North America, 2006 to 2009.

Participants: A total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0 ± 12.9 years).

Intervention: Diet, exercise, and stress management.

Main Outcome Measures: Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG).

Analysis: The researchers used t test and McNemar chi-square test of proportions, at P < .05.

Results: Reductions were significantly greater …

A Positive Association Between Cryptosporidiosis Notifications And Ambient Temperature, Victoria, Australia, 2001-2009, Lillian Kent, Michelle Mcpherson, Nasra Higgins

Lillian Kent

Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001-2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1°C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (IRR 1.22; 95% CI 1.13 – 1.31). In the rural area, a …

Australian Graduating Nurses’ Knowledge, Intentions And Beliefs On Infection Prevention And Control: A Cross-Sectional Study, Brett G. Mitchell, Richard Say, Anne Wells, Fiona Wilson, Linda Cloete, Lucinda Matheson

Linda Cloete

Background: In recent year, national bodies have been actively addressing the increasing concern on the spread of healthcare-associated infections (HAIs). The current study measures the knowledge, intentions and beliefs of third-year Australian nursing students on key infection prevention and control (IPC) concepts.

Methods: A cross-sectional study of final-year undergraduate nursing students from Schools of Nursing at six Australian universities was undertaken. Students were asked to participate in an anonymous survey. The survey explored knowledge of standard precautions and transmission based precautions. In addition intentions and beliefs towards IPC were explored.

Results: 349 students from six universities completed …

The Effect Of Exercise On Cognitive Function As Measured By Impact Protocol: Aerobic Vs. Anaerobic, John Brutvan Ma, Atc, Kimberly S. Peer Edd, Atc, Fnata, Jacob E. Barkley Phd, Jay Jonas Ms, Atc

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Background: Exercise has long played a critical role in the recovery from athletic injuries. Of recent, concussion research has escalated creating new insights into the treatment of and rehabilitation from concussion syndromes. As part of the concussion research, multiple uses of the ImPACT tool have evolved to measure cognitive function. However, combining the variables of cognitive improvement as measured by the ImPACT protocol with aerobic and anaerobic exercise has not been investigated. Purpose: The purpose of this investigation was to assess the influence of acute bouts of aerobic versus resistance exercise on cognitive function of college-aged participants as measured …

Today - September / October 2016, Loma Linda University Health

TODAY

Inside this issue:

- Behavioral Medical Center celebrates 25 years
- Loma Linda University Medical Center - Murrieta celebrates five years of service
- Navigating Nichol Hall's labyrinth: there's an app for that
- Henry the hamster teaches elementary children in San Bernardino how to be healthy
- Believe Walk 9th annual event celebrates fight against cancer
- Festivities mark the return of LLU students to the campus
- United and dedicated: Convocation service encourages student success with God's help
- LLUMC-Murrieta receives Advanced Comprehensive Stroke Center designation
- Quadruplets and their parents return to Loma Linda University Children's Hospital …

The Costs Of Cancer, Jamie Mosely

Honors Papers and Posters

This poster explores the relationship between more advanced cancer-fighting technologies and the increase in healthcare costs over the last several decades, and the socioeconomic impact this has for patients with less disposable income or no health insurance.

Young People’S Perceptions Of Advice About Sexual Risk Taking, Christopher Donoghue, Consuelo Bonillas, Jennifer Moreno, Melissa Cheung

Department of Sociology Faculty Scholarship and Creative Works

Sexual and reproductive health indicators for young people in the USA have improved in recent decades, but teenage pregnancies remain high, and large differences between Whites and non-Whites persist in teenage births, abortions, and the acquisition of sexually transmitted infections. Prior research shows that young people are receptive to communication about sex from parents and friends, but peers have been found to be more influential on sexual risk taking. In this study of 617 young people aged 13–20 years in high-risk neighbourhoods for teenage pregnancy in New Jersey, we asked whether sexually inexperienced young people differed from sexually experienced young …

An Anthropometric Risk Index Based On Combining Height, Weight, Waist, And Hip Measurements, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Body mass index (BMI) can be considered an application of a power law model to express body weight independently of height. Based on the same power law principle, we previously introduced a body shape index (ABSI) to be independent of BMI and height. Here, we develop a new hip index (HI) whose normalized value is independent of height, BMI, and ABSI. Similar to BMI, HI demonstrates a U-shaped relationship to mortality in the Third National Health and Nutrition Examination Survey (NHANES III) population. We further develop a new anthropometric risk index (ARI) by adding log hazard ratios from separate nonlinear …

Sample Size Formulas For Estimating Intraclass Correlation Coefficients In Reliability Studies With Binary Outcomes, Mengxiao Xu

Electronic Thesis and Dissertation Repository

Introduction: Measurement errors can seriously affect quality of clinical practice and medical research. It is therefore important to assess such errors by conduct- ing studies to estimate a coefficients reliability and assessing its precision. The intraclass correlation coefficient (ICC), defined on a model that an observation is a sum of information and random error, has been widely used to quantify reliability for continuous measurements. Sample formulas have been derived for explicitly incorporation of a prespecified probability of achieving the prespecified precision, i.e., the width or lower limit of a confidence interval for ICC. Although the concept of ICC is applicable …

Mater: Innovative Programs For Maternal Addiction Education Treatment And Research, Meghan Gannon Phd Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Developing Hyperpolarized Silicon Particles For In Vivo Mri Targeting Of Ovarian Cancer, Nicholas Whiting, Jingzhe Hu, Niki M. Zacharias, Ganesh L. R. Lokesh, David E. Volk, David G. Menter, Rajesha Rupaimoole, Rebecca Previs, Anil K. Sood, Pratip Bhattacharya

Nicholas Whiting

A Rare Association Of Giant Cell Arteritis With Recurrent Corneal Ulcer, Sailaja Bondalapati, Kay Khine, Maya Bitar, David Chesnutt, Richard M. Davis

Ophthalmology

We report a rare case of association of temporal arteritis with recurrent central corneal ulcer. A 91-year-old male with a remote history of clinically diagnosed giant cell arteritis (GCA) and penetrating keratoplasty (PK) for corneal edema in 1990’s in the left eye presented with irritation and severe dry eye. He progressively developed central corneal ulcer regardless of treatment with aggressive lubrication and patching. The clinical course, blood tests and temporal artery biopsy results yielded the diagnosis of recurrent GCA. The clinical course improved after starting oral steroids. The case report illustrates the importance of ruling out GCA in patients with …

Today - August 2016, Loma Linda University Health

TODAY

Inside this issue:

-- Health Disparities Research Symposium recognizes young researchers and their contributions
-- More than 3,000 attend All Star Appreciation Game at San Manuel Stadium
-- Alumnus addresses Republican National Convention
-- Murrieta neurosurgeon honored for health care excellence
-- Blood supplies challenged: your donation can help save a life
-- ASI convention provides opportunity to share mission and vision
-- 17th annual Nursing Research and Evidencebased Practice Conference attended by 150
-- Senior VP of finance recognized—again— by leading industry publication
-- Service learning: a classroom in the community
-- Student testimonies and statistics paint MITHS successes …

Alumni Journal - Volume 87, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
10 | An Unexpected Visit
12 | APC 2016 in Review
24 | Medicine, Faith, and Hope

Departments
2 | From the Editor
4 | From the President
6 | From the Dean
7 | The Student Fund
8 | School of Medicine News
42 | AIMS Report
46 | Alumni News
48 | In Memoriam
52 | Historical Snapshot
53 | What's Up Doc?

Extras
3 | New Executive Director
11 | Class Giving Report
49 | Tribute to Lawrence D. Longo '54

Potentially Inappropriate Medication Use In Older Patient With Breast And Colorectal Cancer, Meghan S. Karuturi

Dissertations & Theses (Open Access)

Our objective was to determine predictors of potentially inappropriate medication (PIM) use and its impact on outcomes (including ER visits, hospitalization, all cause death, and composite of three) in breast and colorectal cancer patients receiving chemotherapy. We used data from the SEER database linked to Medicare claims. Our cohort included patients ≥ 66 years diagnosed with of Stage II/III breast or colorectal cancer between 7/1/2007-12/31/2009. Baseline PIM was defined using the Drugs to Avoid in the Elderly list (DAE) or Beers criteria. Univariate and multivariable logistic regression were used to determine the associations of baseline PIMs with different covariates. Event-free …

An Evaluation Of African American Fathers’ Perceptions And Influences On Child Food Choices And Physical Activity Behaviors, Valerie Annette Richardson

Dissertations

Child obesity is affecting children’s health nationwide. Rates are highest among African Americans (AA) in the South. Research has explored parents’ influence on child eating and activity, but most has reported on mothers’ influences. The purpose of this research was to investigate perceptions about AA fathers’ influences on their children’s eating and physical activity. Using a structured focus group questionnaire based on the parent layer constructs of Birch and Ventura’s Ecological Model for Child Overweight (2009), four focus groups were conducted with 28 AA fathers with children 6- to 11-years-old in a rural and an urban church setting in southeast …