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Alumni Journal - Volume 90, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | Guest Editorial: Tiffany C. Priester '04
4 | From the President
7 | From the Dean

News
8 | This and That
10 | APC Preview
12 | School of Medicine News
14 | Students
15 | Wedding Announcements
16 | Alumni News

Missions
18 | Missions Feature - inspiring stories from the mission field

Features
45 | Alumni Spotlight - Lloyd Rudy Broomes '66
46 | Canadian Rockies Alumni Trip
50 | Department Report: Otolaryngology
53 | The Storm of Our Shores [Book review]

In Memoriam
53 | Featured Obituary - Stanley G. Sturges '55
54 …

Decision And Persuasion: Re-Conceiving The Role Of The Planner Where Undue Influence Is Suspected, James C. Milton, Katheleen R. Guzman

ACTEC Law Journal

No abstract provided.

Live Peabody: An Age-Friendly Action Plan, Caitlin Coyle, Beth Rouleau

Center for Social and Demographic Research on Aging Publications

The vision of the Live Peabody Initiative is to inspire change in the City of Peabody so that residents of all ages and abilities can thrive. The success of this initiative is dependent on the involvement of a dedicated and passionate group of residents and stakeholders that will proactively spearhead this age-friendly effort. These individuals will actively collaborate with civic, business and non-profit organizations as well as state and local government officials to heighten awareness of the age-friendly movement and implementation of the action items outlines in this report—all to spur positive change for the City of Peabody. This report …

Washington Regional Student Nurse Internship-Cardiology, Lillie Watson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The Student Nurse Internship Program was started as a way to allow nursing students to gain the skill set of patient care and communication while allowing us additional educational opportunities. The first 4 weeks of my internship were the orientation period in which 2 weeks we followed a nurse and then the other 2 weeks we followed a nursing assistant. These initial 4 weeks really gave us the opportunity to have educational opportunities by following the nurse, but also allowing us to work with another nursing assistant before working on our own. Through my internship at Washington Regional, I was …

Development Of A Clinical Guideline And Algorithm To Enhance Self-Efficacy In Non-Compliant Chronic Disease Patients, Karen Alexander

Doctoral Scholarly Projects & Capstones

This scholarly project was a nonexperimental quality improvement project to create a practice care guideline and algorithm with the intention of enhancing self efficacy in non-compliant chronic disease patients within the primary care setting. The objectives of the clinical guideline and algorithm were to assist primary care providers in identifying low self-efficacy in chronic disease patients, provide guidance in selection of interventions to develop or improve self-efficacy in patients, and promote better disease management. The guideline outlines tools and techniques to give primary care providers the information and skills needed to improve strategies to counsel patients to become more active …

Adolescent Future Orientation: Does Culture Matter?, Rachel Seginer

Online Readings in Psychology and Culture

Future orientation, or the image individuals have of the future, provides the grounds for setting goals and planning, and therefore is considered an important adolescent developmental task. This chapter introduces future orientation research by describing its evolvement from a thematic approach focusing on the content of future domains to a model consisting of three components, discusses its universal and cross-cultural meanings, and reports a replicated finding that across cultures, adolescents share a common core of future orientation domains consisting of education, career, and marriage and family. Based on findings on effects of the family setting on future orientation and an …

An Evidence-Based Intervention To Reduce The Use Of Physical Restraints In A Female Adolescent Population At An Inpatient Psychiatric Unit, Mambo Ndingwan

Doctor of Nursing Practice

The use of physical restraints within psychiatric units is problematic since it raises a range of legal, ethical, and clinical questions (American Psychiatric Nurses Association, 2014). The use of physical restraint has become a common practice in many psychiatric units despite the negative effects associated with its use. Selecting strategies such as verbal de-escalation to manage aggressive psychiatric inpatients shows promise with patients when used by providers and staff in mental health facilities. The purpose of this evidence-based project was to introduce and train staff to utilize the Modified Overt Aggression Scale (MOAS) and verbal de-escalation in psychiatric units in …

Serum Myostatin And Igf-1 As Biomarkers Of Sarcopenia: A Proof-Of-Concept Design, Ashley Binns

Graduate Theses and Dissertations

The population comprising older adults is growing exponentially, as are healthcare related costs. Nearly $20 billion is annually expensed by older adults for health-related issues affiliated with age-related decline in skeletal muscle mass. Yet, diagnostic criteria are not readily utilized in clinical practice. PURPOSE: Therefore, the purpose of this study was to provide evidence for use of blood biomarkers (myostatin, IGF-1) to predict appendicular skeletal muscle mass (ASM) among middle-aged and older adults. METHODS: A cross-sectional study was conducted among 106 individuals (n = 68 females; n = 38 males) aged ≥ 40 years of age (60.1 ± 11.1 y) …

Functional Analysis In The Home Setting Of An Older Adult With Neurocognitive Disorder, Emily Norton

Masters Theses

Currently within the behavioral gerontology literature there are no published studies that include a functional assessment in the home setting. The primary goal of the present study was to address this gap by conducting a functional analysis on a challenging behavior of an older adult with neurocognitive disorder in the home. This study occurred in two phases. During phase one, researchers conducted an antecedent functional analysis on the bizarre speech of an 81-year-old female with suspected dementia across four conditions (television on, no interactions initiated; television on, interactions initiated; television off, no interactions initiated; television off, interactions initiated). Results from …

Objective Sleep Quality As A Predictor Of Mild Cognitive Impairment In Seniors Living Alone, Brian Chen, Hwee-Pink Tan, Irus Rawtaer, Hwee Xian Tan

Research Collection School Of Computing and Information Systems

Singapore has the fastest ageing population in the Asia Pacific region, with an estimated 82,000 seniors living with dementia. These figures are projected to increase to more than 130,000 by 2030. The challenge is to identify more community dwelling seniors with Mild Cognitive Impairment (MCI), a prodromal state, as it provides an opportunity for evidence-based early intervention to delay the onset of dementia. In this paper, we explore the use of Internet of Things (IoT) systems in detecting MCI symptoms in seniors who are living alone, and accurately grouping them into MCI positive and negative subjects. We present feature extraction …

Factors Related To Adverse Mental Health Condition Of Demented Family Caregivers: A Study In West Bengal, India, Ipsita Basu, Susmita Mukhopadhyay

Journal Articles

Dementia caregiving is a unique and the caregivers faces extreme challenges which affect care-giver's mental health adversely. Family caregiving towards elderly individuals with dementia is becoming widespread. The study aims to evaluate the mental health status of dementia family caregivers and some related factors that affect their mental health condition. Present cross sectional study includes a total of 134 family caregivers. Socio-demographic and caregiving related data were collected using pre-tested questionnaires. Standardized questionnaires were used to collect data on caregivers' mental health traits (measured in terms of level of stress and anxiety), level of psychosocial distress, support they provided and …

Counseling Students’ Attitudes Toward Complementary And Alternative Medicine Integration In Counseling Practice, Lee Za Ong, Carrie L. King, Hope A. Jackson

College of Education Faculty Research and Publications

This study explored counseling students’ attitudes toward beliefs and personal experience with complementary and alternative medicine (CAM) integration in counseling practices. A total of 113 clinical mental health counseling students completed a demographic questionnaire, the CAM use, and the Complementary and Alternative Medicine Beliefs Inventory. Data were analyzed using descriptive statistics, nonparametric Chi-Square testing, Mann–Whitney U test, and logistic regression analysis to determine the prevalence of CAM use, CAM beliefs, and predictive factors of CAM integration. The results indicated differences in ethnicity, gender, and age for CAM use, CAM beliefs, and predictors of attitudes toward CAM integration. Recommendations for counseling …

Impact Of Project Echo Models Of Medical Tele-Education: A Systematic Review, Ryan K. Mcbain, Jessica L. Sousa, Adam J. Rose, Sangita M. Baxi, Laura J. Faherty, Caroline Taplin, Andre Chappel, Shira H. Fischer

Project ECHO Bibliography

BACKGROUND: Extension for Community Healthcare Outcomes (ECHO) and related models of medical tele-education are rapidly expanding; however, their effectiveness remains unclear. This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improved provider- and patient-related outcomes.

METHODS: We searched English-language studies in PubMed, Embase, and PsycINFO databases from 1 January 2007 to 1 December 2018 as well as bibliography review. Two reviewers independently screened citations for peer-reviewed publications reporting provider- and/or patient-related outcomes of technology-enabled collaborative learning models that satisfied six criteria of the ECHO framework. Reviewers then independently abstracted data, …

Nursing And Midwifery Links [December 2019 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

In this edition of the Links Magazine, we highlight the current issues, research, innovations, and perspectives of these institutions around palliative care. We recognize the importance of this human right and the role nurses and midwives have in advancing care for those in need of palliative health services. As is made evident in this publication, there are important areas where timely, evidence-based, and strategic efforts are needed to ensure that individuals are effectively cared for across the lifespan and varying levels of health and wellness. By promoting awareness and collaboration around this global health priority, we can ensure a healthier …

Fraud Prevention For Seniors, Claudia Rodriguez

Capstone Projects and Master's Theses

The senior population has been a target for fraudulent crimes. The determined contributing factors for the senior population being susceptible to fraud is being gullible, lacking knowledge of strategies to prevent fraud, and having cognitive decline due to aging. Fraudulent crimes can have major consequences such as, monetary cost, negative effects on health and unreported cases. Fraudulent crimes against seniors is a growing issue and must be addressed. In order to address this issue within the community a capstone project was developed and implemented in collaboration with the Monterey County District Attorney's Office of Consumerism and Environmental Protection Division. This …

Rural Aging: The Geographic Reach Of Service Access In Utah, Identifying Barriers And Solutions, Alexandra T. Schiwal

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

This dissertation includes two studies of rural age-related services in the state of Utah. The first study combines geospatial, demographic data (number of people over 55) and age-related services (hospitals, hospice providers, nursing homes, senior centers, and Areas Agencies on Aging) at the county level and census-tract level to determine localized differences in proportional access to age-related services. Higher and lower proportions are then predicted by contextual factors including rural/urban gradient, economic industry, and broadband access. Results demonstrate that broadband access was significantly associated with higher access to age-related services, but being a retirement destination (increase in people over 65 …

Human-Animal-Environment Interactions As A Context For Child And Adolescent Growth, Erin Flynn, Alexandra Zoller, Megan Mueller, Kevin Morris

Journal of Youth Development

Human-animal-environment interaction (HAEI) is increasingly used in special education. While most research of HAEIs has identified effects that broadly support positive special education outcomes, further research of HAEI-based interventions in these environments is needed. Semi-structured interviews were conducted with 18 teaching staff at a special education school that utilizes a range of HAEIs. The teachers are responsible for implementing evidence-based interventions to facilitate social-emotional learning (SEL), so assessing their unique perspectives on the impacts of HAEIs on student SEL outcomes is imperative. Phenomenological coding of the interviews identified 9 major themes that represented positive impacts as well as barriers and …

Age And Seasonal Change In The Chronobiology Of A Spider With An Exceptionally Long-Period Circadian Clock, Shae Crain

Electronic Theses and Dissertations

This study examines locomotor activity in samples of Frontinella pyramitela collected over its active season (April-October) to investigate whether seasonality and/or age may help explain the exceptional variability typically found in spider clock systems. Despite its noteworthy variability (%CV= 7.7), we have found that Frontinella has a mean free-running period of 28.4±2.18 hours that does not significantly vary over time. There is no correlation between day length and free-running period, indicating that varying length of FRP is not a function of photoperiod length. In LD 12:12 h, the window of activity is significantly smaller in April, gradually widening as the …

The Role Of The Environmental Context In Advance Care Planning Among Older Adults, Brittany E. Gaines

Graduate Doctoral Dissertations

Research has focused on various individual characteristics associated with advance care planning (ACP), but little is known about how the environment context is associated with ACP. This study examined the role of environmental characteristics in ACP by addressing three key aims: 1) examine the independent effects of environmental factors on ACP, 2) assess the moderating effects of environmental factors on the associations between ACP and individual household income and educational attainment, and 3) conduct a longitudinal examination of ACP and environmental characteristics. I combined individual ACP information from the 2004 and 2011 waves of the Wisconsin Longitudinal Study with county …

Appmod: Helping Older Adults Manage Mobile Security With Online Social Help, Zhiyuan Wan, Lingfeng Bao, Debin Gao, Eran Toch, Xin Xia, Tamir Mendel, David Lo

Research Collection School Of Computing and Information Systems

The rapid adoption of Smartphone devices has caused increasing security and privacy risks and breaches. Catching up with ever-evolving contemporary smartphone technology challenges leads older adults (aged 50+) to reduce or to abandon their use of mobile technology. To tackle this problem, we present AppMoD, a community-based approach that allows delegation of security and privacy decisions a trusted social connection, such as a family member or a close friend. The trusted social connection can assist in the appropriate decision or make it on behalf of the user. We implement the approach as an Android app and describe the results of …

Staff Perceptions Of Quality Interactions In Dementia Care, Rebecka A. Schultz

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The national aging trend suggests that population of those aged 65 and older will reach 83.7 million by the year 2050. With increasing age comes the growing possibility of one getting some form of dementia. The Alzheimer’s Association expects the number of American’s with dementia to triple from the reported 5 million cases in 2014 by 2050. With a rise in this cognitively impaired population there is reason to look closely at the needs of persons with dementia living in residential facilities and whether or not they are being met. The main focus of residential facilities is to provide aid …

The Role Of Social Support In Dementia Care Facilities: Staff Member Perspectives, Malinda K. Dokos

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

In this study, certified nursing assistants (CNAs) who work regularly with long-term care residents with dementia were interviewed to investigate whether they considered providing social and emotional support to people with dementia an important part of their jobs. They were given an online survey, then each participated in an in-person interview that was recorded and later transcribed and analyzed for common themes. Through data analysis, I found that the participating CNAs unanimously considered social support to be an important aspect of caring for someone with dementia, and several personal values were associated with this perspective. They also reported the trainings …

Genome-Wide Meta-Analysis Of Macronutrient Intake Of 91,114 European Ancestry Participants From The Cohorts For Heart And Aging Research In Genomic Epidemiology Consortium, Jordi Merino, Hassan S. Dashti, Sherly X. Li, Chloé Sarnowski, Anne E. Justice, Misa Graff, Constantina Papoutsakis, Caren E. Smith, George V. Dedoussis, John Blangero

School of Medicine Publications

Macronutrient intake, the proportion of calories consumed from carbohydrate, fat, and protein, is an important risk factor for metabolic diseases with significant familial aggregation. Previous studies have identified two genetic loci for macronutrient intake, but incomplete coverage of genetic variation and modest sample sizes have hindered the discovery of additional loci. Here, we expanded the genetic landscape of macronutrient intake, identifying 12 suggestively significant loci (P < 1 × 10-6) associated with intake of any macronutrient in 91,114 European ancestry participants. Four loci replicated and reached genome-wide significance in a combined meta-analysis including 123,659 European descent participants, unraveling two novel loci; a common variant in RARB locus for carbohydrate intake and a rare variant in DRAM1 locus for protein intake, and corroborating earlier FGF21 and FTO findings. In additional analysis of 144,770 participants from the UK Biobank, all identified associations from the two-stage analysis were confirmed except for DRAM1. Identified loci might have implications in brain and adipose tissue biology and have clinical impact in obesity-related phenotypes. Our findings provide new insight into biological functions related to macronutrient intake.

The Impact Of A Multisensory Stimulation Environment Within A Memory Care Assisted Living Facility, Dana M. Prince

Dissertations

The use of Multisensory Stimulation Environments (MSSE) has grown increasingly more common in the United States (U.S.) as a nonpharmacological intervention for Behavioral and Psychological Symptoms of Dementia (BPSD). However, typical MSSE designs require a secluded room isolated from outside stimulation and demand direct supervision from the care provider during treatment. Due to projected shortages in the clinical workforce and the population of older adults on the rise, a study was designed to reveal the effectiveness of an open-floorplan MSSE to reduce the demand of care providers during the use of the MSSE while allowing subjects diagnosed with dementia to …

The American Unreformation: The Undoing Of American Evangelical Prominence And The Rise Of The Religiously Unaffiliated Nones, H G. Walker

Doctoral Dissertations and Projects

With over sixty percent of Protestant churches in America experiencing either plateaued or declining numbers, the ineffectiveness or outright inattention to evangelistic efforts is magnified by the aggressive growth of the Nones population; therefore, this dissertation project seeks to answer one central question related to the current increase in the number of Americans identifying as religiously unaffiliated: Are there identifiable religious resurgence mechanisms in American religious history that address the current rise of the Nones and if initiated would facilitate future religious resurgence? Lower levels of religious affiliation reveal a weakening of the heart of the Evangelical position on evangelization …

Users’ Perception Of The Hospital Information System In A Maternity Hospital In Lampung, Indonesia, Al Asyary, Arief Kurniawan Nur Prasetyo, Tris Eryando, Solvay Gerke

Kesmas

Hospital information systems (HIS) have been applied on a massive scale; however, user evaluation of their effectiveness, efficiency, and service quality improvements remain rare. This study aimed to describe the utility of information systems from the users’ point of view by using the Technology Acceptance Model (TAM) in a maternity hospital in Lampung, Indonesia. The study provided an overview of the features of the information system and the workflow of the user through this information system. Screenshots were taken by using Camtasia Studio 2.0 Trial Version application software for one day (two shifts) in the outpatient service. The HIS generally …

Major Depressive Disorder Among Individuals Who Are Deaf: Implications For Rehabilitation Professionals, Sandra Hansmann, Shawn P. Saladin, Diana Fraser-Mendez

JADARA

Major Depressive Disorder (MDD) is a potentially disabling condition which adversely affects psychosocial functioning in the lives of many people. Individuals who are prelingually and/or profoundly Deaf are especially at risk of misdiagnoses, which in turn may prevent them from receiving the treatment needed to reach their full potential in independent living or vocational rehabilitation. This article reviews general depressive symptomology, followed by a discussion of challenges associated with diagnosing MDD in individuals who are Deaf. Suggestions for therapeutic interventions are also included. The article concludes with a summary of the implications of Deafness and MDD for independent living and …

Towards Actionable Knowledge: A Systematic Analysis Of Mobile Patient Portal Use, Cherie Noteboom, Mohammad Al-Ramahi

Research & Publications

As the aging population grows, chronic illness increases, and our healthcare costs sharply increase, patient portals are positioned as a central component of patient engagement through the potential to change the physician-patient relationship and enable chronic disease self-management. A patient’s engagement in their healthcare contributes to improving health outcomes, and information technologies can support health engagement. In this chapter, we extend the existing literature by discovering design gaps for patient portals from a systematic analysis of negative users’ feedback from the actual use of patient portals. Specifically, we adopt a topic modeling approach, latent Dirichlet allocation (LDA) algorithm, to discover …

Drug Interactions With Antimalarial Medications In Older Travelers: A Clinical Guide, Jelena Lewis, Tania Gregorian, Ivan Portillo, Jeff Goad

Pharmacy Faculty Articles and Research

Increasingly older adults are traveling to international destinations with malaria as a present risk. Surveillance systems indicate that older adults are more likely to suffer severe complications from malaria. The role of health care providers in selecting an appropriate medication for chemoprophylaxis or treatment of malaria in adults becomes more difficult as older adults undergo physiologic changes that alter the pharmacokinetic and pharmacodynamic nature of medications potentially causing increased drug interactions, adverse events, and altered drug action. A comprehensive literature search from 1970 to present, with a focus on the last 10 years, was conducted on drug interactions, pharmacokinetic and …

2019 November 25 - Graduate Council Minutes, College Of Graduate And Continuing Studies, East Tennessee State University

Graduate Council Agendas and Minutes

No abstract provided.