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Alumni Journal - Volume 93, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4| From the President
6 | From the Dean

News
8 | School of Medicine News
10 | Alumni News
11 | This and That
12 | Students
14 | AIMS Report
16 | Department Report: Gynecology and Obstetrics

Graduation 2022
19 | Graduation Feature

Features
34 | By the Graduates
38 | Graduate Medical Education at LLUH
42 | Curriculum Transformation
46 | Historical Snapshot
47 | Alumni Spotlight

In Memoriam
49 | Alumni Remembered: Featured obituaries - George T. Harding IV '53-B; John W. Mace '64

Describing Healthcare Concerns Of Young People And Adults With Cerebral Palsy, Christina M. Winger

Electronic Thesis and Dissertation Repository

The purpose of this study was to identify healthcare concerns of young people and adults with cerebral palsy (CP) in the Transitional and Lifelong Care (TLC) program, and determine whether there were patient factors associated with the number of healthcare concerns. A retrospective chart review of initial TLC consultations was completed (n = 241). Descriptive and inferential statistics were used to explore and explain patterns in the sample population. The participants reported a high number of concerns of varied nature that were not easily predicted by condition-specific or demographic variables. This study may better healthcare delivery for young people …

Language-Based Strategies That Support Person-Centered Communication In Formal Home Care Interactions With Persons Living With Dementia, Reanne G. Mundadan

Electronic Thesis and Dissertation Repository

Background. Several studies recommend language-based strategies for communication with persons living with dementia. Language-based strategies improve coherence, clarity, reciprocity, and continuity of interactions. Person-centered communication (PCC) strategies are the gold standard, including facilitation, recognition, validation, and negotiation. Only one study has examined the overlap between language-based strategies and PCC in long-term care. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Method. Conversation analysis of 30 audio-recorded routine care interactions between home care workers and persons living with dementia was conducted. The …

Can Hope Be Primed In Chronic Pain? A Clinical Application Of Health Priming, Brenda Stockdale

Educational Studies Dissertations

ABSTRACT

It is recognized that nonintentional, automatic processing shapes physical health and well-being in critical ways. Conditioning––or priming––has been shown to influence attitude, beliefs, agency, behavior, and medical outcomes. Although expectations and beliefs correlate strongly with physical health, research in clinical application is needed, and studies on hope, as related to agency, in chronic pain are rare. The purpose of this study was to investigate whether, in a chronic pain sample (N = 154), hope could be primed via a Pain Neuroscience Educational (PNE) tutorial. A pre- and post-test intervention study consisting of two randomized parallel groups was designed …

Improving The Coordination Of Care For Periprocedural Antithrombotic Medication Management In Patients Undergoing Elective Surgery, Joyce Larson

Doctor of Nursing Practice Scholarly Projects

Background: Arranging periprocedural antithrombotic medication (ATM) management is a frequently encountered complex clinical challenge. Often, there is limited time between the pre-admission clinic visit and the surgical date to coordinate ATM management and communicate the plan to the patient. This increases the risk of perioperative adverse events, case delays and cancellations, and is a patient safety concern. A quality improvement project was undertaken to address improving ATM periprocedural care coordination for patients taking ATM undergoing elective surgery. A review of the literature found clinical decision support system (CDSS) alerts to be an effective strategy. The aim of the project was …

Exploring Research Knowledge, Attitude, And Practice Of Mnri® Core Specialists, Jerzie-Ann Coppola

Seton Hall University Dissertations and Theses (ETDs)

Statement of the Problem: The Masgutova Method® is a research emergent area with a growing yet limited research base. In order to facilitate a widespread and robust acceptance and integration of The Masgutova Method® as evidence-based practice, a significant increase in research is warranted. MNRI® Core Specialists are well-positioned to be scholars in The Masgutova Method®. At this time, there is no literature exploring MNRI® Core Specialists’ foundational research knowledge, attitude toward research, and research practice.

Purpose of the Study: The purpose of this study is to establish a baseline understanding of MNRI® Core Specialists’ research knowledge, attitude, and practices. …

Development Of A Community Hospital Medicine Affiliated Inpatient Rotation For Family Medicine Residents - A Collaborative Success, David M. Gallagher, Anthony J. Viera, William E. Bynum, Poonam Sharma, John W. Ragsdale, Jeffrey Eschbach, Lalit Verma

Journal of Community Hospital Internal Medicine Perspectives

Background: Hospitalists perform key roles as inpatient educators for family medicine residents. For the past decade, Duke University Family Medicine Residency Program had its inpatient family medicine resident rotation at non-Duke facilities.

Objective: The authors describe the steps taken in 2020 to develop an inpatient Duke family medicine rotation at a North Carolina community hospital, Duke Regional Hospital, and provide outcomes data.

Methods: Duke Family Medicine Residency and Duke Regional Hospital Medicine collaborated in addressing key issues to develop an inpatient rotation for family medicine residents. Performance metrics of patients cared for by both the family medicine inpatient resident team …

Uno Student Access To Emergency Contraception: A Needs Assessment, Annika Kuchar

Theses/Capstones/Creative Projects

Emergency contraception (EC) is a common method of contraception that helps prevent ovulation before implantation of an egg inside a uterus. Among college students, EC can be utilized to prevent unplanned pregnancies that could potentially prevent someone from completing their degree. College students can face unique barriers when trying to access EC including transportation, privacy, financial, or mental/emotional barriers. The purpose of this study was to determine what barriers students at the University of Nebraska at Omaha (UNO) face when trying to access EC, and what future accommodations they would utilize if given the option. The study surveyed 147 UNO …

Associations Of Lifestyle And Sociodemographic Factors With Dietary Supplement Use In College Students, Sydney Chratian

Senior Honors Projects

Background: Dietary supplement use has been shown to be significantly prevalent in the United States, especially among the young adult population. Studies have reported increasing use of dietary supplements among college students in the US. However, little research has investigated the sociodemographic and behavioral characteristics associated with dietary supplement use in this population.

Objectives: The aim of this study was to examine the prevalence of dietary supplement use and sociodemographic and behavioral characteristics associated with dietary supplement use in college students and examine the attitudes and beliefs of college students on dietary supplements.

Methods: A cross sectional study was conducted …

Comparison Of Short Chain Volatile Fatty Acids In The Breastmilk Of Normal And Overweight/Obese Mothers, Ellen Gaskill, W Andrew Clark, Kristy L. Thomas, Amy Wahlquist, Michelle E. Johnson

Undergraduate Honors Theses

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body …

Adapting And Responding To A Pandemic: Patient And Family Advisory Councils In Children's Hospitals During Covid-19, Pam Dardess, Deborah L. Dokken, Ndidi I. Unaka, Jesse Hsu, Mindy Hoang, Andrew F. Beck, Beverley H. Johnson

Patient Experience Journal

This mixed-methods study investigated the effects of the COVID-19 pandemic on Patient and Family Advisory Councils (PFACs) within children’s hospitals in the United States. Specifically, the study sought to understand how PFACs adapted operations as a result of the COVID-19 pandemic, how patient and family advisors (PFAs) were engaged in the response to COVID-19, and the intersection of the COVID-19 pandemic with PFAC diversity, equity, and inclusion. The study consisted of a survey distributed to 228 children’s hospitals, with a 73% response rate, and in-depth interviews with selected survey respondents (n=12). While COVID-19 temporarily disrupted PFAC operations and forced rapid …

Book Review: The Ophthalmic Laser Handbook, William L. Miller Od, Ms, Phd

Optometric Clinical Practice

Book Review: Freisberg L, Lighthizer N, Skorin, Jr. L, Stonecipher K, and Zimmerman A. The Ophthalmic Laser Handbook. First Edition. Wolters Kluwer Health; 2021. $102.00, 350 pages, Paperback ISBN: 978-1975170172, e-book ISBN: 978-1975170219

Case Report: Bartonella Quintana-Associated Neuroretinitis, Kelly Seidler Od, Kelly A. Malloy Od

Optometric Clinical Practice

Background: Neuroretinitis is a self-limiting condition which typically causes monocular vision loss with good potential for visual recovery. It may be idiopathic or associated with infectious or inflammatory conditions which can carry systemic implications. Neuroretinitis classically presents with disc edema followed by development of a macular star pattern of exudates. It is most commonly attributed to Cat Scratch Disease, or Bartonella henselae infection. However, there have been few published reports of Bartonella quintana associated neuroretinitis.

Case Report: A 60-year-old patient presented with unilateral vision loss preceded by flu-like illness. The patient had exposure to a recently adopted cat. …

Bilateral, Full-Thickness Macular Holes While Undergoing Chemotherapy, Sarah Dieter Od, Brett Garee Od Ms, Susan Zacatelco Od, Julie Henry Od

Optometric Clinical Practice

Background: Bilateral, full-thickness macular holes are a rare condition that can substantially affect quality of life. Macular hole diagnosis and treatment is key for these patients.

Case Report: A 71 year old Caucasian male presented with a chief complaint of distance blur in both eyes, worsening over the past 1-2 weeks. He had no diagnosis of diabetes. He added that his prostate cancer had spread and that his last treatment ended 9 days ago. He was ultimately diagnosed with bilateral, full-thickness macular holes. Referral to a retinal specialist for surgical management yielded good results.

Conclusion: This is …

Cefuroxime-Induced Toxic Maculopathy: A Cataract Co-Management Conundrum, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Background: Cefuroxime-induced toxic maculopathy can occur when an incorrect dilution is injected intracamerally after cataract surgery. This results in a guarded visual prognosis. Cefuroxime-induced toxic maculopathy can also occur sporadically even when the medication dilution is the standard correct dosage. These patients usually recover their vision by the first postoperative week.

Case Report: A 72-year-old Caucasian female developed cefuroxime-induced toxic maculopathy after uneventful cataract surgery. Investigation of the case confirmed that she had a sporadic response to the cefuroxime. It was verified that she received the standard correct dilution of cefuroxime intracamerally. The patient showed a significant improvement in her …

Medication-Induced Oculomotor Dysfunction: A Report Of Two Cases, Eric Lee Od

Optometric Clinical Practice

Background: Consideration of current medications and their interactions as a source of new onset oculomotor dysfunction is imperative for providing good eye care. Medication etiology should be particularly suspected when the symptoms begin with the initiation of a new medication and resolved with discontinuation of the same medication.

Case Reports: Presented are two cases demonstrating that it is prudent to be aware of medications capable of inducing oculomotor dysfunction. Each case reveals instances of acute oculomotor dysfunction after the initiation of a central nervous system affecting medication. Case 1 details a partial pupil sparing third nerve palsy after initiating the …

Longstanding Crystalline Retinopathy Secondary To Intravitreal Triamcinolone Injection, Katherine Thomas Od, Jeffery Curry Od

Optometric Clinical Practice

Background: Crystalline retinopathy has many disparate etiologies with varying potentials in visual outcome. Due to the potential severity of these outcomes, differentiation of etiology is critical to guide both follow up and treatment regimen. Diagnosis can be facilitated with a thorough medical history, clinical presentation, and imaging such as optical coherence tomography (OCT).

Case Report: This case demonstrates a rare incidence of crystalline retinopathy in a 65-year-old male attributed to a single intravitreal triamcinolone acetonide (IVTA) injection with 8 year follow up data, followed by a review of other types of crystalline retinopathy secondary to pharmaceutical agents.

Conclusion: A complete …

It’S As Easy As Learning To Fly A Plane, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Radiographic Predictors Of Functional Outcome In Degenerative Lumbar Spondylolisthesis Surgery, Patrick Thornley

Electronic Thesis and Dissertation Repository

Objective: To confirm the importance of sagittal spinal alignment on functional outcome with degenerative lumbar spondylolisthesis (DLS) surgery and to identify the radiographic parameters that predict functional outcomes after DLS surgery.

Methods: Retrospective analysis of the prospectively collected functional and radiographic outcomes of the Canadian Spine Outcomes and Research Network DLS database. All patients underwent either decompression, posterolateral fusion or interbody fusion surgery with a minimum of one-year postoperative follow-up.

Results: Most patients improve or remain unchanged in their sagittal spinal alignment regardless of surgery type with fusion procedures not experiencing statistically significantly improved alignment changes to decompression alone. By …

Surgical Intervention With Adjunctive Cryotherapy For Canine Conjunctival Hemangiosarcomas Versus Hemangiomas, Lisa M. Hoard

Biomedical Engineering ETDs

Conjunctival hemangiomas and hemangiosarcomas are vascular tumors that affect the tissue in the eyes of canines. While relatively rare, these tumors can be costly to remove, and have a possibility of recurrence. Therefore, more understanding of the nature of these tumors and recurrence rates is of importance to the veterinary ophthalmologist. To date, there is limited data in the literature (2 retrospective studies) that examine the development, treatment, and recurrence of these vascular tumors; furthermore, the analyses do not examine the potential recurrence of tumors after treatment with therapies adjunctive to surgery (such as cryoablation, radiotherapy, and others). For this …