Other Medicine and Health Sciences Commons^™

Distinct Neuropsychological Profile And Associated Neurochemical Changes In Individuals With Mitochondrial Encephalomyopathy, Lactic Acidosis, And Stroke-Like Episodes (Melas), Emily B. Leaffer

Dissertations, Theses, and Capstone Projects

Background: Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) is a maternally inherited progressive multisystemic disorder. Occurrence of seizure and/or stroke-like episode, as well as classic biomarkers (i.e., cerebral lactic acidosis, depleted N-acetylaspartate (NAA)), have been linked to neuropsychological deficit and trigger the developmental cascade of neurodegeneration affecting posterior prior to anterior brain regions. While a pattern of global deterioration has been reported, systematic examination in a large MELAS cohort has not been conducted.

Objective: First, we examined verbal and visual memory function and its relationship to brain metabolites (lactate, NAA) in individuals with MELAS. Second, we hypothesized that MELAS …

Implementation Of A Screening Protocol To Improve Provider Assessment Of Depression In Patients With Psoriasis, Marlee Bryant

Doctoral Dissertations and Scholarly Projects

Patients with psoriasis are at an increased risk for depression. Despite this risk, many dermatology care providers do not screen for depression in practice, including providers at the target practice for this project. This evidence-based practice pilot project was purposed to increase dermatology providers’ assessment of depression in patients with psoriasis. This project involved implementing a depression screening protocol at one private dermatology practice and educating providers on the use of the protocol including the embedded depression screening tool, the Patient Health Questionnaire-9. The project leader used a quasi-experimental design and collected data utilizing retrospective chart reviews completed pre- and …

Alumni Journal - Volume 89, Number 2, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Features
14 | True Sustenance
17 | Department Reports: Pediatrics and Obstetrics and Gynecology
24 | APC 2018 Review

Departments
2 | From the Editor
4 | From the President
6 | From the Dean
9 | This and That
10 | School of Medicine News
12 | AIMS Report and Awards
13 | The Student Fund
34 | Book Review
37 | Classified/Placement Ads
38 | Alumni News
39 | In Memoriam
43 | Historical Snapshot
44 | What's Up Doc? - Daniel L. Bouland '82

Extras
8 | New Board of Directors Members and Alumni Association Officer

Uams Summer Health Literacy Study, Merritt Osment

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Health Literacy is a barrier to self-care; patients often lack the skills to understand complicated instructions that deal with medications, wound care, follow up schedules, and preventative care. Patients who undergo hip and knee replacements are often older adults, a population that normally struggles with various aspects of health literacy. Patient education materials are a common means of communicating with these individuals. However, if the patient does not understand the materials that they are given, they are more likely to experience negative side effects after their operation. Purpose: The purpose of this study is to compare the health literacy …

An Opportunity For Pharmacists To Help Improve Coordination And Continuity Of Patient Health Care, Jon C. Schommer, Lawrence M. Brown, Ryan (Alyssa) Bortz, Alina Cernasev, Basma T. Gomaa, Keri D. Hager, Lisa Hillman, Olihe Okoro, Serguei V. S. Pakhomov, Paul L. Ranelli

Pharmacy Faculty Articles and Research

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, …

Development And Implementation Of A Homogeneous And A Heterogeneous Anthropomorphic End To End Quality Assurance Audit System Phantom For Magnetic Resonance Guided Radiotherapy Modalities Ranging From 0.35 T To 1.50 T, Angela Steinmann

Dissertations and Theses (Open Access)

Introduction: Magnetic resonance (MR) guided radiation therapy (MRgRT) is an emerging field that integrates an MR imager with either a linear accelerator or three radioactive cobalt-60 sources. Before institutions participate in multi-institutional NCI-sponsored clinical trials, they are required to perform a credentialing test provided by IROC-Houston. During the credentialing test, end-to-end phantoms are used to evaluate the institution’s ability to perform consistent and accurate radiation treatments. IROC-Houston’s conventional anthropomorphic phantoms are not visible in MR, thus they are insufficient for MRgRT systems. The purpose of this work was to create an anthropomorphic thorax and a head and neck (H&N) phantom …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Improving Health And Well-Being: Connecting Research And Practice. The 24th Annual Conference Of The Health Care Systems Research Network, Karen L. Margolis, Nico Pronk, Jane E. Duncan, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The 24th annual conference of the Health Care Systems Research Network (HCSRN, formerly the HMO Research Network), held April 11–13, 2018, in Minneapolis, Minnesota, attracted 357 attendees. The HCSRN is a consortium of 18 community-based research organizations embedded in or affiliated with large health care delivery systems. Its annual research conference, held since 1994, is a unique venue that brings diverse stakeholders (eg, research teams, clinicians, patients, funders) together to explore a range of health research topics and scientific findings, with a unifying goal of connecting applied research to real-world care delivery for the betterment of individual and community health. …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

Cancer - The Formidable Opponent, Loma Linda University Health

Scope

Table of Contents:

Features
14 | Mark Reeves on a cancer diagnosis
16 | Genetic testing
17 | Immunotherapy
18 | Psychosocial support
21 | Myths of clinical trials
22 | Treating cancer in children
24 | Hope for stage IV patients
26 | Treating leukemia in the surrounding Hispanic population
28 | Turning off a cell's switching mechanism
29 | Prompting leukemia cells to die
30 | Cancer-fighting foods
32 | Finding answers and treatments with California's cancer database
34 | Mapping cancer screening
36 | History of our proton therapy
37 | Out next step in battling cancer …

An Interprofessional Education Initiative For Allied Health Students Preparing To Serve Individuals With Autism Spectrum Disorders, Brenda L. Beverly, Donna Wooster

University Faculty and Staff Publications

The need for effective services for persons with autism spectrum disorders (ASD) is driving efforts to better prepare teams of allied health professionals. To address this need, an interprofessional graduate course was piloted with students from three allied health professions: physical therapy, occupational therapy, and speech-language pathology. The course aims were to address knowledge and competency in the field of ASD and to promote interprofessional abilities during entry-level preparation. Nine graduate students participated in weekly on-line education and attended a day-long autism conference with local practitioners from seven different professions. Attitude changes toward interprofessional practice were assessed with two pre- …

Exposure To Household Air Pollution From Biomass-Burning Cookstoves And Hba1c And Diabetic Status Among Honduran Women, S. Rajkumar, M. L. Clark, B. N. Young, Megan L. Benka-Coker, A. M. Bachand, R. D. Brook, T. L. Nelson, J. Volckens, S. J. Reynolds, C. L'Orange, N. Good, K. Koehler, S. Africano, A. B. Osorto Pinel, J. L. Peel

Health Sciences Faculty Publications

Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle‐income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross‐sectional study of 142 women (72 with traditional stoves and 70 with cleaner‐burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24‐hour average kitchen and personal fine particulate matter [PM2.5] mass and black carbon) …

Parkinson’S Disease Support Groups In Rural America: Barriers, Resources, And Opportunities, Erin J. Bush, Reshmi L. Singh, Mary Jo C. Hidecker, Catherine Phillips Carrico

The Qualitative Report

People with Parkinson’s disease who live in rural communities may lack information and support regarding their condition, compared to those in urban or suburban areas. For the study described herein, the researchers sought to gain a deeper understanding of support group experiences of rural Parkinson’s disease stakeholders through merging an interpretive phenomenological design with Community-based Participatory Research (CBPR). Using this merged approach, we collected qualitative data from five focus groups to gain a community perspective. The qualitative data was analyzed thematically, first, and then further explored for an overall essence. The theme, Support Group Benefits: Opportunities for Communication expounded upon …

Patient Acceptance Of Remote Scribing Powered By Google Glass In Outpatient Dermatology: Cross-Sectional Study, Sandra Odenheimer, Deepika Goyal, Veena Jones, Ruth Rosenblum, Lam Ho, Albert Chan

Faculty Publications

Background: The ubiquitous use of electronic health records (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and can disrupt patient-health care provider (HCP) nonverbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted technology (FMT), such as Google Glass, may preserve patient-HCP communication dynamics in health care settings by allowing providers to maintain direct eye contact with their patients while still having access to the patient’s relevant EHR information. The medical scribe is able to chart patient encounters in real-time working in an offsite location, …

Today - June 2018, Loma Linda University Health

TODAY

Inside this issue:

-- School of Medicine honors Leonard Bailey’s contributions to infant heart transplant field
-- School of Pharmacy graduates encouraged to find value in life beyond work
-- School of Dentistry graduates begin their professional journeys
-- Allied Health Professions graduates encouraged to share love of Jesus with their future patients
-- School of Public Health graduating class represents 25 nations
-- Schools of Religion, Behavioral Health graduates encouraged to serve others
-- School of Nursing celebrates milestone as 10,000th graduate receives degree
-- University President’s Award winners announced for 2018
-- 42 graduate from San Manuel Gateway …

Commencement Program 2018, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2018 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | Criteria for Institutional Awards—Loma Linda University and Loma Linda University Health

15 | Loma Linda University Health and Loma Linda University Honorees

32 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 33
• School of Pharmacy, 63
• School of Dentistry, 76
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, …

Understanding The Factors Influencing The Perception Of Organizational Sustainability Among Healthcare Professionals (Hcps) Post The Patient Protection And Affordable Care Act, Funso A. Olufade

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Healthcare costs in the United States has continued to increase annually, and new policy's attempt at protocol changes in healthcare practices does not ensure quality care delivery. An example of these policies include provisions and new guidelines under the 2010 healthcare legislation, - The Patient Protection and Affordable Care Act (ACA). The premise with the Affordable Care Act (ACA) is increased healthcare access for patients. However, not responsibly balancing the increased demand with the escalating cost of care creates an unsustainable system (Department of Health & Human Services, 2015). Healthcare organizations, including hospitals …

Imagination Station: Activating Creativity In Children With Disabilities, Allison Dukes

Expressive Therapies Capstone Theses

Play is a major topic of conversation when discussing childhood development is associated with creativity and imagination. Although there has been some research involving the creative process amongst children, little has been explored in regards to expressive arts as a technique to further current studies on play. This paper presents a combined method of intermodal expressive arts therapies and play therapy techniques to aid in the fostering of creativity within children with disabilities by utilized the theoretical framework provided by the Expressive Therapies Continuum (ETC). A current review of literature on the ETC, cognitive functions, and expressive arts modalities is …

Thermoregulatory Dysfunction In Multiple Sclerosis, Dustin R. Allen

Applied Physiology and Wellness Theses and Dissertations

Multiple sclerosis (MS) is a progressive neurological disease of the central nervous system (CNS) affecting an estimated 2.3 million people worldwide. Marked by lesions in the brain and spinal cord, MS leads to conduction abnormalities in the CNS. Evidence suggests ~60% of individuals with MS experience temporary worsening of their symptoms upon exposure to heat. Adding complexity, observational evidence suggests these individuals exhibit reduced thermoregulatory responses in upon increases in core temperature. Consequently, these individuals face a vicious cycle of heat sensitivity and thermoregulatory dysfunction, substantially impacting their quality of life. With this in mind, our lab is dedicated to …

Energy Expenditure Performing Hands-Only Cardiopulmonary Resuscitation During Average Emergency Response Times, Johnathan Valdez, Savanna Edson, Micha Emmel, Jesus Rivera-Macias, Benjamin Adams, Mary Casilla

2018 Symposium

Early cardiopulmonary resuscitation (CPR) by civilian responders is a critical aspect in the survival of cardiac arrest patients. According to the American Red Cross (ARC), the average response time to a 911 call is 8-12 min. High-quality CPR performed as soon as possible following cardiac arrest considerably increases a person’s chances of survival and recovery. It is possible that fatigue may decrease CPR quality, and to date no data exists on the metabolic cost of preforming hands-only CPR. PURPOSE: To determine the energy expenditure of performing hands-only CPR during the average emergency response time. METHODS: Eight college-aged participants (23.6 ± …