Other Medicine and Health Sciences Commons^™

The Creation And Implementation Of Guidelines For The Appropriate Termination Of Patient-Provider Relationships, Rowena D. Nolasco

Doctor of Nursing Practice (DNP) Projects

Primary care providers have terminated patient-provider relationships when they deem them no longer therapeutic. Healthcare providers are increasingly considering this an acceptable practice. However, the criteria for this decision remain unclear. As providers discharge challenging or difficult patients from their practices, questions to support this decision arise. Discharged patients face displacement and healthcare is disrupted. This project will (a) describe problematic patient-provider relationships and its effects, (b) identify possible alternatives to the firing of patients, (c) list appropriate reasons for termination, and (d) present recommended procedures to avoid allegations of medical abandonment. The project's product is an Appropriate Discharge or …

Segmentation And Strain Mapping Of A Beating Heart, Kenna Middleton

McKelvey School of Engineering Theses & Dissertations

Conventional methods of estimating deformation optically often compare image intensities before and after deformation to help estimate the strain fields. However, these current meth ods often introduce undesirable error that propagates through the system, growing larger through each strain calculation. These errors create false, concentrated regions of strain throughout the image. Additionally, gathering and evaluating images in three- and four dimensional space creates even more difficulty for conventional methods. Here, by imple menting new techniques of gathering four-dimensional ultrasound data sets and calculating deformation fields with traditional errors reduced three-fold, four-dimensional images were evaluated to create a novel visualization tool …

A Parallel-Group Randomized Controlled Trial Of The Boa®-Constricting Iv Band, Richard N. Bradley

Richard N Bradley

Background. Few studies have demonstrated the ideal technique for placement of peripheral venous access.

Objectives. The purpose of this study was to conduct a randomized, controlled trial to determine if there was a difference in success rates for establishing peripheral intravenous lines (IVs) when using the BOA® Constricting Band (BOA) compared to a standard elastic tourniquet.

Methods. Eligible participants were paramedics working in the out-of-hospital setting and nurses working in a trauma center. The intervention group intended to use the BOA® for all IV attempts, while the control group intended to use standard elastic tourniquets. The primary outcome was success …

Exploring Acceptance Of Using An Online Platform To Teach Parents Of Children With Autism Methods In Applied Behavior Analysis (Aba), Marwah S. Zagzoug

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: A diagnosis of autism can lead to lifelong struggles for parents and children. These families face profound difficulties in coping with stress while seeking out early interventions and managing imperative service needs. Parents are increasingly turning to the internet for information, advice, and even formal training. Breakthroughs in technology have made the internet more accessible and more sophisticated. The involvement of parents in applying intervention strategies to help their autistic children has long been advocated as a useful approach. Enabling parents as interventionists provides renewed confidence and reduced stress for parents as well as …

Potential Cellular Mechanisms Of Estrogen's Effects On Maintaining Sperm Production In Aging Rats, Matthew Pate

Honors Theses

Testosterone production by Leydig cells declines during aging in both men and rodent models. Previous results from our lab demonstrated that daily sperm production also declines in aging rats and alterations in the estrogen environment of the testis contribute to this decline. Importantly, estrogen treatment during aging was able to attenuate the age-associated decline in sperm production. However, the cellular and molecular mechanisms by which estrogen maintains sperm production remain unclear. These experiments were designed to further investigate the effects of estrogen on sperm production in an attempt to further define the cellular mechanisms regulated by estrogen within the testis. …

Professional Ethics: What You Should Know, Ann Obergfell

Ann M. Obergfell

No abstract provided.

Medical Law, Ann Obergfell

Ann M. Obergfell

No abstract provided.

Street Drug Markets Beyond Favelas In Belo Horizonte, Brazil, Elenice De Souza De Souza Oliveira, Braulio Figueiredo Alves Silva, Marcos Oliveira Prates

Department of Justice Studies Faculty Scholarship and Creative Works

This study examines whether social disorganization mechanisms that explain clusters of street drug markets in socially disorganized neighborhoods in developed countries can also help explain geographical patterns of drug dealing across neighborhoods in Belo Horizonte, Brazil. Data for this study includes drug arrests from 2007 to 2011 and socio demographic data from the 2010 Census. To examine the influence of exploratory variables on drug market locations, the Negative Binominal regression model was used at two levels of analysis—the Belo Horizonte city center and other neighborhoods including favelas. The findings show that a high hot spot of street drug markets located …

Alumni Journal - Volume 86, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
10 | A Call for Medical Missionaries
12 | They Helped to Establish This Noble Legacy
14 | The Evolution of Graduation
22 | Graduation 2015

Departments
2 | From the Editor
3 | This and That
4 | From the President
5 | From the Dean
6 | The Student Fund
8 | School of Medicine News
38 | AIMS Report
40 | Book Review
42 | Alumni News
43 | In Memoriam
49 | What's Up Doc?

Extras
24 | Note from the Class of 2015 President
48 | 1 Corinthians 13 - Revised Medicalized Version

Muscle Cramping During A 161-Km Ultramarathon: Comparison Of Characteristics Of Those With And Without Cramping, Martin D. Hoffman, Kristin J. Stuempfle

Health Sciences Faculty Publications

Background: This work sought to identify characteristics differing between those with and without muscle cramping during a 161-km ultramarathon.

Methods: In this observational study, race participants underwent body weight measurements before, during, and after the race; completed a post-race questionnaire about muscle cramping and “near” cramping (controllable, not reaching full-blown cramping), drinking strategies, and use of sodium supplementation during four race segments; and underwent a post-race blood draw for determination of serum sodium and blood creatine kinase (CK) concentrations.

Results: The post-race questionnaire was completed by 280 (74.5 %) of the 376 starters. A post-race blood sample was provided by …

Today - December 2015, Loma Linda University Health

TODAY

Inside this issue:

-- Terrorist bullets shatter the peace of the holidays in San Bernardino and neighboring communities
-- Loma Linda University Health family remembers victims
-- Advancement team Christmas gathering reflects tragedy and hope
-- Media relations ream inundated with inquiries
-- Faculty and students profess solidarity with victims of San Bernardino terrorist attack
-- Flag of Hope promotes unity, peace, and healing
-- Second graders make Christmas cards for LLUMC emergency department
-- Food distribution event at Highland Springs Medical Plaze provides food supplies for local area families in need
-- Charity Navigator gives LLU coveted 4-star rating …

Mechanisms By Which Dietary Ellagic Acid Attenuates Obesity And Obesity-Mediated Metabolic Complications, Inhae Kang

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Ellagic acid (EA) is a polyphenol found in various fruits and plants, such as berries, pomegranates, muscadine grapes, nuts and bark of oak tree. EA has been known to exhibit anti-inflammatory and anti-proliferative effects in various types of cancer. However, little is known about the effects of EA on obesity. Herein, 1) the lipid-lowering role of EA was identified in primary human adipose stem cells (hASCs) and human hepatoma Huh7 cells; 2) the molecular mechanisms by which EA attenuates adipogenesis by epigenetic modification were identified; 3) the effects of EA on high fat and high sucrose-mediated obesity was …

Fair Weight Loss After Gastric Rebanding For Slippage, Ahmed Dalmar, Maharaj Singh, Sara K. Roloff, Thomas Y. Chua

Journal of Patient-Centered Research and Reviews

Background: Laparoscopic adjustable gastric banding (LAGB) is one of the most common bariatric surgery procedures performed in the United States. LAGB results in safe and satisfactory weight loss, but it is often complicated with slippage, a complication requiring rebanding (reoperation). There is a paucity of studies and no uniform consensus regarding weight loss after rebanding.

Purpose: This study assessed the effect of rebanding for slippage after LAGB on weight loss up to five years.

Methods: This is a historical cohort study of 865 patients who underwent LAGB from 2001 to 2011. Rebanding was performed in 103 (11.9%) patients. Primary outcome …

Collaborative Diagnosis: Interdisciplinary Problem-Solving Between Physicians And Lawyers, Robert Pettignano, Lisa Bliss, Sylvia Caley

Sylvia B. Caley

Patient and client-centered practice and accurate problem diagnosis require that we understand the context within which the patient/clients’ problem originated. Effective problem solving depends upon context-specific solutions. This article describes the interaction of a medical clinician/educator and two legal clinicians/educators who work and teach together as part of an interdisciplinary community collaboration. We demonstrate how a pediatric hospital and two medical schools that treat acutely and chronically ill children collaborate with a legal services clinic based in a law school to provide interdisciplinary clinical education for students and engage in interdisciplinary problem solving for the benefit of patients and clients. …

Today - November 2015, Loma Linda University Health

TODAY

In this issue:

-- First hospital-based proton center hosts celebratory events with reunion of hundreds of former patients and families
-- SAC Health Systems celebrates 20 years of health care to San Bernardino residents
-- New global initiative brings dermatological telemedicine to rural communities on the African continent
-- Loma Linda University Health employees enjoy excellent health care benefits and low premiums
-- The Children's Hospital and Proton Treatment and Research Center: a rare combination
-- Team-building program at Drayson Center brings people together through play
-- More than 2,000 people attend Family Health Fair and 5k run
-- Dishes …

Evaluation And Treatment Of Lower Extremity Wounds In A Vascular Surgery Patient Population, Christine Anne Murphy

Electronic Thesis and Dissertation Repository

Purpose

To determine in a population with lower extremity wounds associated with vasculopathy if: (1) previously proposed clinical signs of infection are valid indicators of wound infection; (2) low frequency (22.5 kHz) contact ultrasound debridement (LFCUD) is well tolerated and feasible to apply in a nurse-led vascular wound clinic; (3) healing outcomes are improved for patients receiving LFCUD in comparison to patients receiving usual care (UC).

Methods

A total of 80 patients were in the study. First, a pilot group of ten patients were followed to determine tolerability, feasibility and wound response of 4 weekly LFCUD treatments. Then 70 patients …

Raising The Bar: Improving The Research Skills Of Undergraduate Strength & Conditioning Interns, Lara Sapp

Lara Sapp

Loma Linda University Health - San Bernardino Groundbreaking, Loma Linda University Health

Scope

Table of Contents

Features

2 | New facility in San Bernardino to enhance opportunities
4 | Loma Linda shares its story with world church

Campus news

8 | Historic step taken toward unified governance
9 | Quarter-century milestones celebrated
10 | School of Public Health conferences lead the way

Clinical care

11 | Children’s Hospital receives separate license
11 | Pediatric ICU celebrates 25 years of service
12 | Clinicians train with FEMA for disasters
14 | Woman regains her life through bariatric surgery

Research

15 | Grant enables purchase of next-generation DNA sequencer
16 | Potholes and primordial mysteries: …

Current Opinion In The Role Of Testosterone In The Development Of Prostate Cancer: A Dynamic Model, Xiaohui Xu, Xinguang Chen, Hui Hu, Amy B. Dailey, Brandie D. Taylor

Health Sciences Faculty Publications

Background: Since the landmark study conducted by Huggins and Hodges in 1941, a failure to distinguish between the role of testosterone in prostate cancer development and progression has led to the prevailing opinion that high levels of testosterone increase the risk of prostate cancer. To date, this claim remains unproven.

Presentation of the Hypothesis: We present a novel dynamic mode of the relationship between testosterone and prostate cancer by hypothesizing that the magnitude of age-related declines in testosterone, rather than a static level of testosterone measured at a single point, may trigger and promote the development of prostate cancer.

Testing …

Today - October 2015, Loma Linda University Health

TODAY

Inside this issue:

-- Pro surfer and shark attack survivor Bethany Hamilton speaks at PossAbilities luncheon and fundraiser
-- Murry Brandstater honored by donor through special gift
-- Perryman named administrator for Loma Linda University Children's Hospital
-- Chinnock appointed Children's Hospital chief medical officer
-- Becker named director of Loma Linda University Health office of public relations
-- ENT professors teach vocal and choral students to protect their voices
-- Internal medicine residency program celebrates 50 years
-- Loma Linda University Health awarded $1.4 million grant for San Bernardino Campus
-- Corky's Cookies raises $10,000 for pediatric cancer treatment …

Development Of Soft-Matter Delivery Systems: Coupling Ph Responsive Polymers To Porous Silica Particles, Andrew Gomez

Biomedical Engineering ETDs

This work investigates polymeric coating of evaporated induced self-assembly (EISA) mesoprous silica nanoparticles for potential use in controlled drug release and therapeutics. As demonstrated here, lipid bilayer coatings can be easily replaced with different polymer analogs allowing for dynamic response to environmental stimuli. In addition to coupling commercially available diblock polymers we synthesized and characterized a unique dual hydrophilic pH responsive diblock copolymer, PEO-PAA. This hybrid polymeric-nanoparticle system drastically improves targeting and release capabilities through the modular ability to couple multiple different polymers. Furthermore, this work is supported by an improved method to form and study giant polymer vesicles (pGVs)

Today - September 2015, Loma Linda University Health

TODAY

Inside this issue:

-- Anonymous donor honors three long-time Loma Linda physicians
-- LLUMC - Murrieta accredited as chest pain center
-- SAC Health System granted new status by federal government
-- Nursing dean attends executive training at Wharton School
-- Congressman tours Children's Hospital and research facilities
-- Leadership team from Naval Hospital Twentynine Palms visits Medical Center
-- LLUMC - Murrieta to hold Family Health Fair on Sept. 27
-- School of Public Health presents 'Asthma Theatre' program at Riverside County Office of Education Head Start training
-- End-of-life issues explored and discussed during screening of the PBS …

Alumni Journal - Volume 86, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
8 | Interview: To Know the Truth
12 | Rec Hall No More
16 | APC 2015 in Review
30 | Law and Medicine

Departments
2 | From the Editor
3 | This and That
4 | From the President
5 | From the Dean
6 | School of Medicine News
42 | AIMS Report
44 | Alumni News
45 | In Memoriam
48 | Historical Snapshot
49 | What's Up Doc?

Extras
14 | 2014 Class Giving Report
19 | Dr. Bob's Programs
31 | The Good Samaritan (a poem)
40 | Leaving a Mark on Dr. Shryrook

Today - August 2015, Loma Linda University Health

TODAY

Inside this issue:

-- Final beam is placed for Loma Linda University Health - San Bernardino in topping-off ceremony
-- Loma Linda University Transplantation Institute leads all of Southern California in liver transplant survival
-- Cancer Center receives UniHealth Foundation grant
-- Innerweave The Wholeness Story
-- Center for Health Disparities holds annual research symposium
-- Off to work . . . one woman's story of retirement
-- Cheng Family Foundation presents $75,000 gift to Loma Linda University Eye Institute for children's intervention program
-- IndyCar racer visits Children's Hospital outpatient clinic
-- Loma Linda University Health reaches out to …

Negative Skeletal Effects Of Locally Produced Adiponectin, Marcia J. Abbott, Theresa M. Roth, Linh Ho, Liping Wang, Dylan O'Carroll, Robert A. Nissenson

Health Sciences and Kinesiology Faculty Articles

Epidemiological studies show that high circulating levels of adiponectin are associated with low bone mineral density. The effect of adiponectin on skeletal homeostasis, on osteoblasts in particular, remains controversial. We investigated this issue using mice with adipocyte-specific over-expression of adiponectin (AdTg). MicroCT and histomorphometric analysis revealed decreases (15%) in fractional bone volume in AdTg mice at the proximal tibia with no changes at the distal femur. Cortical bone thickness at mid-shafts of the tibia and at the tibiofibular junction was reduced (3–4%) in AdTg mice. Dynamic histomorphometry at the proximal tibia in AdTg mice revealed inhibition of bone formation. AdTg …

Paramedicine And Social Work: Case Studies In Authentic Student Recruitment, Nathalie Collins, Lynelle Watts, Renee Strauss, David Hodgson

eCULTURE

Selling the course experience to future students has been corporatised across the Higher Education sector. At many universities marketing and sales specialists, such as ECU’s Student Recruitment Team, rather than academic staff, field prospective student enquiries. Representing courses authentically is crucial to matching future students with an appropriate course experience and career, as well is managing future students’ expectations. A challenge for academics is communicating the course/career experience to university sales agents (recruiters). A challenge for recruiters is conveying an authentic course experience to future students when they have not taken a course themselves. This paper selects two ECU courses, …

Medicare Secondary Payer And Settlement Delay, Eric Helland, Jonathan Klick

All Faculty Scholarship

The Medicare Secondary Payer Act of 1980 and its subsequent amendments require that insurers and self-insured companies report settlements, awards, and judgments that involve a Medicare beneficiary to the Centers for Medicare and Medicaid Services. The parties then may be required to compensate CMS for its conditional payments. In a simple settlement model, this makes settlement less likely. Also, the reporting delays and uncertainty regarding the size of these conditional payments are likely to further frustrate the settlement process. We provide results, using data from a large insurer, showing that, on average, implementation of the MSP reporting amendments led to …

Statement Of The Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015, Tamara Hew-Butler, Mitchell H. Rosner, Sandra Fowkes-Godek, Jonathan P. Dugas, Martin D. Hoffman, Douglas P. Lewis, Ronald J. Maughan, Kevin C. Miller, Scott J. Montain, Nancy J. Rehrer, William O. Roberts, Ian R. Rogers, Arthur J. Siegel, Kristin J. Stuempfle, James Winger, Joseph G. Verbalis

Health Sciences Faculty Publications

The third International Exercise-Associated Hyponatremia (EAH) Consensus Development Conference convened in Carlsbad, California in February 2015 with a panel of 17 international experts. The delegates represented 4 countries and 9 medical and scientific sub-specialties pertaining to athletic training, exercise physiology, sports medicine, water/sodium metabolism, and body fluid homeostasis. The primary goal of the panel was to review the existing data on EAH and update the 2008 Consensus Statement.¹ This document serves to replace the second International EAH Consensus Development Conference Statement and launch an educational campaign designed to address the morbidity and mortality associated with a preventable and treatable …

Today - July 2015, Loma Linda University Health

TODAY

Inside this issue:

-- Thousands experience Loma Linda University Health at 60th General Conference Session
-- Empowering teachers: EXSEED trains K-12 educators in the art of teaching STEM
-- LLUMC Murrieta named 'Most Wired' by American Hospital Association for second consecutive year
-- Twins overcome insurmountable odds to celebrate first berthday
-- Worldwide delegates from General Conference session tour Loma Linda University Health campus
-- The importance of child health care spans across continents
-- Memory of Cancer Center patients lives on
-- Why go on a mission trip?
-- President's Award recipients represent that University's best
-- Ralph Lee …

Attitudes Toward Death Anxiety And Dying Among Respiratory Therapy Students: A Pilot Study, Kevin Collins, S. Gregory Marshall, Philip Vaughan

Internet Journal of Allied Health Sciences and Practice

Objective: To evaluate relative and absolute reliability and repeatability in assessing median nerve mobility at the level of the wrist and distal upper arm of the right upper extremity during wrist extension. Methods: Six healthy participants participated in the study. Median nerve mobility was captured three times at both sites using Sonocyte Turbo by two sonologists for a total of 72 video clips (36 for each site and 18 by each sonologist). Longitudinal movement was measured using Motion Tracking Analysis Program (MTAP) by the two assessors who were rehabilitation medicine residents. After one month, the assessors remeasured the longitudinal excursion …