Remedy Spring 2013

2 0 1 1 3 SPRING 2013 PUBLISHING SEMIANNUALLY VOLUME 2, ISSUE 2

SPECIAL REPORT:

ORAL HEALTH New Tool to Help Stroke Survivors Communicate

Sun Worshippers Beware Spring/2013 INSIDE KIDS GOING MOBILE笏、RE THEY READY

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Contents Spring 2013

FEATURES

12

medXForce: A New Tool Advancing Communication for Stroke Survivors

BY: (Laura Jarrett)

19

What is an IRB?

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Economics of Employee Education

BY: (Dr. Kayta Kobayashi)

BY: (Dr. Okeleke Nzeogwu)

Hands-On Experience

The All-New Nursing Simulation Lab

BY: (Dr. Brian Oxhorn)

SPECIAL REPORT: ORAL HEALTH Rocky: A True Success Story

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BY: (Rachael Wadley)

Oral Health Research COVER STORY

BY: (Barbara Wood)

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Utah Dental Clinic Now Open at Roseman University

BY: (Tracy Hernanadez)

On the cover: For years many people have viewed dental care and general health care as two isolated things, but instead of focusing on oral health care as something separate from your overall health, patients should consider a semi-annual dental cleaning and examination to be just as important as an annual physical in helping you maintain good health.

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Oral Health and Overall Health

Several recent studies link poor oral health to chronic conditions such as heart disease, diabetes, obesity, Alzheimer's, and even cancer. Roseman University dentists and faculty discuss how you can prevent disease with proper oral care.

BY: (Tracy Hernandez)

DEPARTMENTS EDITORIAL/LETTERS TO THE EDITOR 4 CALENDAR OF EVENTS 5 ARTS & CULTURE: t "DISCOVERING" THE NEW LAS VEGAS CHILDREN'S MUSEUM 6 EXPERIENCING HEALTHCARE COLLABORATION IN GHANA 7 HEALTHY LIVING MENTAL ILLNESS: A TREATABLE MEDICAL DISORDER 8 TOO SLEEPY? 10 SUN WORSHIPPERS BEWARE 11 THE SOURCE: INFORMATION RESOURCES KIDS GOING MOBILE 14 ONLINE RESOURCES FOR ORAL HEALTH 16 ALUMNI NEWS REED HOWE-COLLEGE OF PHARMACY ALUMNUS 34 ROSEMAN PEOPLE 36 Spring/2013 3

SPRING 2013. Vol. 2, No. 2

Assistant Editor Jason Roth

LETTER FROM

Copy Editor Rachael Wadley Editorial Board/Contributors Kitti Canepi Amanda Farr Brenda Griego Eileen Hug Laura Jarrett Dr. Okeleke Nzeogwu Kristi Singer Dr. Elizabeth Unni Barbara Wood Dr. Ron Ziance

Your mouth is a very important part of your body—the ability to chew, swallow, speak, and smile are critical for your health and self-confidence. People who struggle with oral health issues like frequent gum disease, toothaches, and even tooth loss often find that daily tasks can become painful and difficult.

Despite its importance, oral health care is one of the most neglected parts of our overall health as Americans. We have long viewed oral health and physical health as two separate things, but in recent years many researchers and health providers have been making the connection between having good oral health and good overall health.

In this issue of remEDy, we take an in-depth look at the research that links oral disease to a host of other chronic illnesses, including heart disease, diabetes, cancer, and Alzheimer’s, just to name a few.

Guest Contributors Scott Parkin Dr. Kayta Kobayashi Dr. Jed Milne Dr. Brian Oxhorn Photographers Loretta Campbell Kris Carson Francia Garcia Cameron Haymond Designer Billy George

remEDy

is published semi-annually by the Office of Marketing, Roseman University of Health Sciences 11 Sunset Way Henderson, NV 89014 We welcome any comments, questions and submissions. remedymag@roseman.edu 702-968-1633 • 801-878-1035 College of Dental Medicine 702-968-5222 Nevada 801-878-1400 Utah College of Pharmacy 702-968-2007 Nevada 801-878-1053 Utah MBA Program 702-968-2015 Nevada 801-878-1111 Utah College of Nursing 702-968-2075 Nevada 801-878-1062 Utah

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© 2013 Roseman University of Health Sciences

EDITOR

THE

Editor Tracy Hernandez

We also look at some easy solutions that you can implement at home to improve your oral health and reduce your risk of developing gum disease that has been shown to contribute to other chronic illnesses. Seeing a dentist is a critical piece of your total oral health care, so we encourage everyone to visit a dentist regularly, whether it is at The Dental Clinic at Roseman University’s South Jordan, Utah campus, or at your local dentist’s office.

In Nevada, the Orthodontic Clinic at Roseman University recently had the opportunity to work with Rocky Marks, a baby born with a cleft palate. Fortunately Dr. Glenn Roberson, a staff member of the Orthodontic Clinic at Roseman University, is trained to perform a ground breaking treatment method called Nasoalveolar Molding (NAM), and he and several colleagues from the Southern Nevada medical community provided treatment for Rocky at no cost so he would be able to develop normally and to prevent future oral health issues. You can read more about Rocky’s inspiring story in this issue.

In other sections, Roseman pharmacy students recount their experience accompanying a medical mission to Ghana, we take a look at new FDA recommendations for women using sleep aids, and get to see some of the newest technology available—with a new simulation lab in the Nursing department at Roseman’s Henderson campus, and a new app developed by a former Roseman employee who suffered a stroke and is using his experience to help other survivors get the help they need following catastrophic illness.

Sincerely, Tracy Hernandez, Editor

R O S E M A N

U N I V E R S I T Y

O F

H E A L T H

S C I E N C E S

2013 EVENTS Doctor of Dental Medicine (DMD) Information Session May 28, 2013 4:00-6:00 p.m.

College of Dental Medicine - South Jordan Campus 10894 S. River Front Pkwy, South Jordan, UT Event open to anyone interested in learning more about the DMD program. We will offer a tour of the dental school, a presentation about the DMD program and a question and answer session. Please contact the DMD Admissions Office at 801-878-1405 or afarr@roseman.edu to sign up for the event.

APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists June 1, 2013 8:00 a.m. - 6:00 p.m.

South Jordan Campus For more information or to register: www.regonline.com/imzcert13 The International Health & Wellness Expo June 1, 2013 10:00 a.m. - 3:00 p.m.

Gold Coast Hotel & Casino - Arizona room Las Vegas, NV Contact Barbara Wood for more information (702-968-2055, bwood@roseman.edu) Roseman University 2013 Summer Commencement - Henderson Campus Friday, June 7, 2013 9:00 a.m.

Henderson Pavilion Roseman University 2013 Summer Commencement - South Jordan Campus Saturday, June 8, 2013 1:00 p.m.

Kingsbury Hall, University of Utah Doctor of Dental Medicine (DMD) Information Session June 18, 2013 4:00-6:00 p.m.

College of Dental Medicine - South Jordan Campus 10894 S. River Front Pkwy, South Jordan, UT Event open to anyone interested in learning more about the DMD program. We will offer a tour of the dental school, a presentation about the DMD program and a question and answer session. Please contact the DMD Admissions Office at 801-878-1405 or afarr@roseman.edu to sign up for the event.

Summer Break (Campuses Closed) July 1-5, 2013

2013-2014 Academic Year Cora Coleman Senior Center Health Festival July 19, 2013 11:00 a.m. - 3:00 p.m.

Cora Coleman Senior Center, 2100 Bonnie Lane, Las Vegas For more information, contact Barbara Wood (702-968-2055, bwood@roseman.edu) Doctor of Dental Medicine (DMD) Information Session July 30, 2013 4:00-6:00 p.m.

College of Dental Medicine - South Jordan Campus 10894 S. River Front Pkwy, South Jordan, UT Event open to anyone interested in learning more about the DMD program. We will offer a tour of the dental school, a presentation about the DMD program and a question and answer session. Please contact the DMD Admissions Office at 801-878-1405 or afarr@roseman.edu to sign up for the event.

Roseman University Epicurean Experience August 22, 2013 5:30-10:00 p.m.

Ravella at Lake Las Vegas, Henderson, NV Pharmacy White Coat Ceremony - South Jordan Campus August 29, 2013 Utah Cultural Center, West Valley City Pharmacy White Coat Ceremony - Henderson Campus August 30, 2013 Henderson Convention Center Roseman University and Desert View Hospital Health Festival October 12, 2013 9:00-1:00 p.m.

Pahrump, NV For more information, contact Barbara Wood (702-968-2055, bwood@roseman.edu)

For more information about these and other Roseman University events, visit the University’s website at www.roseman.edu/calendar.

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Arts & Culture SPRING 2013

“Discovering” the New Las Vegas Children ’s Museum By: Eileen Hug The Lied Discovery Children’s Museum has been an essential part of Las Vegas since it opened in 1990. Now, more than 20 years later, it’s moving to a brand new location in Symphony Park adjacent to the Smith Center in downtown Las Vegas. Already a favorite (voted the Best Museum by Las Vegas Review-Journal’s readers in the “Best of Las Vegas” survey every year for 20 years), it promises to get even better with the renovation, and attendance is expected to increase as much as 25 percent to 200,000 visitors in the first year alone.

The museum’s previous location on Las Vegas Boulevard North closed at the beginning of February, reopening in the new building on March 9, and with a new name as the Discovery Children’s Museum. In the spirit of renovation, several new hands-on exhibits have been added, with age-appropriate material for every stage of a child’s life, from babies to middle school kids. The highlight of new exhibits is the 60-foot “Summit”, where visitors can “climb, wriggle, pull, and wheel their way through its multilevel learning experiences.”

exhibits from the nation’s leading museums, beginning with George Washington: New Views from Mount Vernon, which was on display through May 15.

Utah’s Museum for Kids While it’s not new, Utah residents can also enjoy great exhibits and hands-on fun at the Discovery Gateway Children’s Museum. It opened in 1978 as the Utah Children’s Museum, then moved to its current location in downtown Salt Lake at the Gateway mall in 2006. The museum boasts six hands-on galleries where children of all ages can learn and play, including the Garden, Kids Eye View, Story Factory, Media Zone, The Studio, and The Terrace. In 2013 the Discovery Gateway Children’s Museum is celebrating 35 years of fun and learning.

There are eight exhibition galleries in addition to the Summit: Toddler Town, Water World, Solve it! Mystery Town, Young at Art, It’s Your Choice (Building a Healthy Lifestyle), Patents Pending, Eco City, and Fantasy Festival. In total, the galleries have 26,000 square feet of interactive hands-on core exhibits.

A separate 5,000-square-foot Featured Exhibition Gallery will accommodate major Las Vegas Discovery Children ’s Museum www.discoverykidslv.org SCHOOL YEAR: SUMMER: Labor Day to Memorial Day Memorial Day to Labor Day Tuesday-Friday, 9 am to 4 pm Monday-Saturday, 10 am to 5 pm Saturday, 10 am to 5 pm Sunday, 12 pm to 5 pm Sunday, 12 pm to 5 pm Closed Mondays

CLOSED ON MAJOR HOLIDAYS: Easter Thanksgiving Christmas Eve Christmas Day New Year’s Day

COST: $12 for anyone age 1 to 99 Free for children under 1, and adults 100 or older Children under 13 must be accompanied by an adult, and all adults must be accompanied by children

Utah’s Discovery Gateway Children ’s Museum www.childmuseum.org YEAR-ROUND HOURS: Monday-Thursday, 10 am to 6 pm Friday-Saturday, 10 am to 8 pm Sunday, 12 pm to 6 pm

CLOSED ON MAJOR HOLIDAYS: Easter Bumble Bee Bash (April) Thanksgiving Day Christmas Day New Year’s Day

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COST: Discounts for pre-registered groups and school groups $8.50 for anyone ages 1 to 64 $6.00 for senior citizens age 65+ Children under 14 must be accompanied by an adult, and anyone over the age of 14 not accompanied by a child must leave a photo Free for children under 1 ID at the desk.

Arts & Culture SPRING 2013

Experiencing Healthcare Collaboration in Kumasi, Ghana By Scott Parkin In May of 2012, fellow Roseman University pharmacy student Caroline Heyrend and I had the opportunity to travel to Ghana, Africa for a 10-day medical mission.

The group we accompanied, consisting of 12 doctors and nurses from the pediatric department of the University of Utah, has been traveling to Africa and working with the Komfo Anokye Teaching Hospital (KATH) in Kumasi for over 16 years.

On their first mission, volunteers from this group carted 89 boxes of supplies to the country and quickly realized that supplies alone do not last long; since that time the group has evolved their practice to focus on sustainable education and collaboration between medical professionals from both countries. Today their efforts contribute to an annual children’s health conference held by the team, attended by hundreds of doctors, nurses, pharmacists, and students from Kumasi looking to gain medical knowledge and expertise.

Ghana is an incredibly beautiful, vibrant, and colorful country, but many of the healthcare facilities are old, outdated, and inadequate. KATH was built in part through funding from the German government, and while some of the adult areas of the hospital are up-to-date and modern, the children’s hospital is badly in need of replacement. Cramped and hot, patients lined floors of the open-air hospital; children were lying on overcrowded mattresses in rooms that looked better suited to be closets. Parents sat on overturned buckets next to their children, feeding and bathing them, sometimes with other children in the room, and a baby wrapped tightly against their back.

Africa faces diseases and conditions that have long been eradicated from the United States. We saw multiple babies with hydrocephalus, their skulls expanded two or three sizes larger than normal. Poor drinking water brings a large amount of people to the hospital with gastroenteritis and other diseases, and limited access to both medication and proper care often leads to unnecessary deaths.

Exploring the KATH pharmacies was both fascinating and devastating. Each area of the hospital has its own pharmacy, but there is no central pharmacy connecting them. Since electricity is not reliable in Ghana, there is no equipment that needs to be plugged in, and without computers, patients’ charts are all hand written. When one

of the medical staff needs medications, the entire chart is delivered to one of the nine pharmacies, dropped off until the pharmacists have time to review the chart and fill the prescriptions, then returned to the area where the patient is being treated.

We were shocked by the lack of medications compared to what we are accustomed to seeing in the pharmacies here. Minimal analgesics (painkillers), limited antibiotics, empty sections on shelves, and endless stories of the difficulties they face on a daily basis. In addition to a severely limited supply, Ghana receives many of its medications from manufacturers in countries like India, where loose inspection and pedigree laws result in fake antibiotics shipped on a regular basis; caregivers often do not know until it is too late.

Another major difference we noticed was in the attitude of the patients we encountered. We spent time in the HIV clinic and had the opportunity to visit with the pharmacist as well as some of the patients. The clinic only operates on certain days of the week and hundreds of patients wait all day to see the pharmacist for life-saving therapy. Unfortunately HIV drugs are in extreme shortage in Ghana, which means patients are often turned away without receiving any medication. Even when they could not get medications, patients left the clinic graciously, always thanking the staff for their time. This attitude persisted throughout the hospital—patients were profoundly grateful to the healthcare staff, and the local healthcare staff members were also profoundly grateful for the help from the volunteer group.

At the end of our trip the group questioned us about the need for pharmacists to be a part of their continued efforts. Caroline and I both agreed adding pharmacists to their conference would help expand the knowledge base of the KATH pharmacy staff, and help support their clinical growth and expertise. We both promised to help build this collaboration and to return with the group in the future. Overall this was a very humbling experience for both of us, and we returned home with a greater appreciation for the access we have to education, technology, medicine, and healthcare.

Neither of us came back the same person—Ghana changed us for the better.

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Healthy Living SPRING 2013

M ental I llness : A Treatable Medical Disorder By: Rachael Wadley

Mental illness as defined by the National Alliance on Mental Illness (NAMI) is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. In many cases the mental illness, whether diagnosed or not, affects a person’s ability to cope with the regular demands of life.

photo by: Images/Rex Features

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Healthy Living SPRING 2013 The Scope of Mental Illness in America Mental illness is everywhere and can affect any individual of any age, sex, race, religion, or income. According to the National Institute of Mental Health (NIMH) one in four adults, or approximately 57.7 million Americans, experience a mental health disorder in a given year. The U.S. Department of Health and Human Services reports that 10 percent of children and adolescents in the United States suffer from serious emotional and mental disorders, and according to NAMI, mental illness usually manifests during adolescence and young adulthood, lasting throughout their entire lives. While it can affect people at any age, the young and old are more prone to being diagnosed with a mental health disorder.

Support and Education About Mental Health Millions of people suffer from physical illness every year, taking medications and using different therapies to remedy the situation. Unfortunately when someone takes medication or uses therapy to cope with mental health illness, there is often the added complication of a social stigma attached.

It is imperative that members of the community are aware of mental illness and exercise patience with those that have been diagnosed. Contrary to some stereotypes, mental illness is not caused by poor upbringing, and those identified with this medical disorder cannot overcome it through their own personal determination. Often the judgmental attitudes and beliefs encountered by people suffering from mental health disorders are counterproductive to getting proper support and treatment.

Treatment Options It is important to remember that mental illness is treatable, and millions of Americans are able to manage these diseases properly, achieving some

normalization and daily functioning through the right mix of medication and therapy. There is no cure for mental illness, though, and treatment often must be continuous to be effective.

According to Mental Health: A Report of the Surgeon General, less than onethird of adults and one-half of children with a diagnosable mental disorder receive mental health services in a given year. The two biggest barriers to receiving proper treatment for mental health disorders are access and cost.

In fact, mental health care access is worse than access to any other type of care in the U.S., with almost 90 million people living in federally-designated Mental Health Professional Shortage Areas, according to a December 2012 Washington Post article. Additionally, many health insurance plans do not offer adequate coverage for mental health services, and almost 50 percent of untreated Americans say cost is the main reason they do not get treatment.

For those who can afford it and do receive it, there are many things used to treat mental illness, including medication treatment in conjunction with cognitive behavioral therapy and interpersonal therapy (often referred to together as “psychosocial treatment”). Peer support groups and other community services can assist with recovery as well. Just like their peers who do not suffer from mental illness, a routine exercise program, adequate sleep, a healthy diet, friends, and participating in paid or volunteer activities can help those with mental illness to recover.

If you are affected by mental illness, you should not be embarrassed. It is important for you to seek help within your community. If you have a loved one or friend who is affected by mental illness, being supportive and helping them receive as much treatment as possible are important to help the person cope with the daily demands of life. Help is out there; it just needs to be utilized.

COMMON MENTAL HEALTH DISORDERS Some of the most common mental illnesses people suffer from include: • Anxiety Disorders • Autism Spectrum Disorders • Attention-Deficit/ Hyperactivity Disorder (ADD/ADHD) • Bipolar Disorder • Borderline Personality Disorder • Depression

• Dissociative Disorders • Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder • Eating Disorders • Obsessive-Compulsive Disorder (OCD) • Panic Disorder

National Mental Health Resources National Alliance on Mental Illness www.nami.org

Substance Abuse and Mental Health Services Administration www.samhsa.gov Mental Health America www.mentalhealthamerica.net http://www.mentalhealthamerica.net/go/information/get-info

Nevada Mental Health Resources Nevada Department of Health and Human Services – Division of Mental Health and Developmental Services www.mhds.state.nv.us NAMI www.namisouthernnevada.org

• Posttraumatic Stress Disorder • Schizoaffective Disorder • Schizophrenia • Seasonal Affective Disorder • Tourette’s Syndrome

Utah Department of Human Services – Substance Abuse and Mental Health • www.dsamh.utah.gov • www.dsamh.utah.gov/mentalhealthtreatment.htm • The Division contracts with Community Mental Health Centers (CMHC) to provide services and monitors these centers through site visits, a year-end review process, and a peer review process.

• www.dsamh.utah.gov/locationsmap.htm • Public-funded services for Substance Abuse and Mental Health

Utah Mental Health Resources NAMI (National Alliance on Mental Illness) Utah (Utah’s Voice on Mental Illness) www.namiut.org 1600 West 2200 South Suite 202 West Valley City, UT 84119 877-230-6264 NAMI Utah’s mission is to ensure the dignity and improve the lives of those who live with mental illness and their families through support, education and advocacy.

Spring/2013 9

Healthy Living SPRING 2013

Too Sleepy?

New FDA FDA Safety Safety Alert Alert For For Women Women Taking Taking New Products Containing Containing Zolpidem Zolpidem Products

By: Dr. Jed Milne

On January 10, 2013 the Food and Drug Administration (FDA) released a safety alert for women taking zolpidem-containing products.

Zolpidem is a commonly prescribed sleep medication found in many brand and generic formulations, including one of the most widely known sleep aids, Ambien and Ambien CR. New safety data from the FDA found blood levels in women remain elevated the morning after taking these products due to a slow zolpidem metabolism, which may lead to morning drowsiness and impaired mental alertness, and can affect daily activities.

The FDA’s safety alert recommends a decrease in the bedtime dose of most zolpidem-containing products for women. Men do not display a slow zolpidem metabolism and are not affected by this new recommendation. However, it is important to understand that morning drowsiness can occur with all medications taken for insomnia in both men and women. Patients can experience impaired mental alertness even if they feel fully awake. The FDA is currently in the process of evaluating dosing for all insomnia medications including over-thecounter sleep aids, and patients are encouraged to report adverse events related to sleep medications to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program located at www. fda.gov/medwatch/report.htm.

Impacts of the New FDA Alert The FDA is requiring a label change for all manufacturers of zolpidemcontaining products to decrease the recommended bedtime dose for women. FDA data shows elevated morning drug levels are obtained more frequently in patients taking controlled-release formulations, but the new safety warning will be included on both immediate and controlled release (CR) products. Patients currently prescribed zolpidem, especially women, should discuss these new changes with their healthcare provider and have dosing adjustments made where needed. Future prescriptions should follow the new FDA dosing recommendations.

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PRODUCTS AFFECTED

• Ambien (zolpidem) immediate-release tablet • Ambien CR (zolpidem) controlled-release tablet • Edluar (zolpidem) sublingual tablet • Zolpimist (zolpidem) oral spray

DOSING RECOMMENDATIONS FOR HEALTHCARE PROVIDERS

It’s important to talk to your doctor or pharmacist before making any changes to dosing for your prescription and over-the-counter medications. As a general guideline, the new dosing recommendations for women taking medications containing zolpidem are: • Decrease immediate-release zolpidem products from 10 mg to 5 mg

• Ambien, Edluar, Zolpimist • Decrease controlled-release zolpidem products from 12.5 mg to 6.25 mg

• Ambien CR • Controlled release tablets should not be cut or split in any way • Intermezzo (zolpidem) sublingual tablet, approved for middle-of-the-night awakenings, is not affected by this new recommendation as women already have an adjusted lower dose compared to men

ADDITIONAL INFORMATION

• FDA News Release http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm334798.htm • FDA Consumer Update http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm322743.htm

Healthy Living SPRING 2013

Sun Worshippers Beware

By Barbara Wood

F

or decades everyone in America wanted to be tan, so we worshipped the sun, lathering our bodies with baby oil, or using tanning beds to achieve that perfect shade of copper. While some sun exposure is an essential part of our overall health, aiding in Vitamin D production, we now know that over-exposure can have dire consequences, and our sun-worshipping habits of old could be putting us in danger.

“The biggest villain is skin cancers, nearly 90% of which are directly caused by exposure to the harmful ultraviolet (UV) rays from the sun,” says John Notabartolo, Dermatology Physician Assistant (PA) for Woodson Dermatology, and president of the Society of Dermatology PAs of Nevada.

If anyone knows about these harmful effects, it’s Notabartolo. He spent four of his 10 years of service in the Air Force as a researcher at the AF Research Lab in San Antonio, studying how non-ionizing radiation affects the eyes and skin. He is a national speaker for several pharmaceutical companies, and an investigator with four ongoing clinical studies.

“Between 50 and 80 patients a week that I see have actinic keratosis, also known as solar keratosis. These are the most common types of pre-cancerous skin lesions caused by longterm exposure to the sun,” says Notabartolo. He continues, “Tanning is not a healthy thing. Our slogan is ‘pale is the new tan’.”

When asked what people can do to prevent skin cancer, Notabartolo suggests:

Wear a tighter weave fabric to allow fewer UV rays to pass through Wear lighter colors to reflect the sun Apply sunscreen whenever you are out in the sun Don’t stay out in the sun as long Check your skin regularly for any new moles or growths and any changes to existing moles If you notice changes from month to month, get to a doctor and get examined to catch it early

He also wants people to remember that you can still get sunburned on a cloudy day, even if it doesn’t feel hot or you cannot see the sun, and you can get sunburned in your car, especially if you have a sunroof, convertible, or you frequently drive with the windows down.

The Dangers of Indoor Tanning Another recommendation from Notabartolo is to avoid indoor tanning facilities, or tanning beds, altogether. According to the American Academy of Dermatology (AAD), more than one million people use indoor tanning beds on an average day. Most of these individuals (70 percent) are Caucasian females between the ages of 16-29, adding up to 28 million people annually who tan indoors, and more than 2 million of those people are teenagers.

“A single bad sunburn as a child doubles your risk of skin cancer as an adult,” says Notabartolo. The AAD points out that studies show a 75 percent increase in the risk of melanoma following exposure to UV radiation from indoor tanning, and the risk goes up with each exposure.

In addition, individuals who use tanning beds before the age of 35 have an 87 percent higher risk of melanoma, and higher risk of premature skin aging, immune suppression, and eye/vision damage.

Seeking shade between 10 am and 4 pm to avoid the strongest sun exposure Wearing broad-brimmed hats, UV-blocking sunglasses, and clothing for cover-up Using a sunscreen with SPF of 15 or greater every day Applying sunscreen at least 30 minutes before going outside, and reapplying every two hours, after swimming, or after excessive sweating Keeping newborns out of the sun Checking your skin every month, and seeing the doctor every year for a professional skin exam New FDA Sunscreen Labels In June 2011 the FDA announced new labeling requirements for sunscreen manufacturers that were scheduled to take effect in June 2012, but after a delay, manufacturers were given a new deadline of December 2012 to comply.

Some smaller manufacturers have until December 2013 to meet new requirements.

Australia and New Zealand have long topped the World Health Organization’s list of countries suffering from skin cancer (likely due to their fair-skinned ancestors who migrated from Europe fairly recently, limiting the ability to adapt to higher sun levels in that country), but the U.S. has even surpassed Australia for skin cancer incidence in recent years. Australia has now outlawed the use of tanning booths.

The most important changes for consumers include the requirement that sunscreen labels distinguish between brands that provide “broad spectrum” protection from both UVA and UVB rays. Only broad-spectrum sunscreens with a sun protection factor (SPF) of 15 or higher can claim to reduce skin cancer risk, while lower SPF or nonbroad-spectrum sunscreens can only claim protection from sunburns. In addition, brands cannot claim to be sweatproof or waterproof, only sweat or water “resistant”, and must include recommendations for reapplication at regular intervals.

Becoming “Sun Safe” According to the Skin Cancer Foundation’s 2007 Guide to Skin Cancers and Precancers, exposure to the sun is cumulative, and each unprotected exposure increases a person’s lifetime risk of developing skin cancer. The Foundation recommends people adapt “sun safety” habits that include:

Have you ever been a sun-worshipper? When was the last time you visited your dermatologist? If the answer is more than a year, now might be a good time to consider scheduling an appointment to talk about your skin health.

When you do plan to go out and enjoy the beautiful sun, read labels, wear sunscreen, and always cover up.

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Innovations SPRING 2013 In 2011, Thomas Runds, former Learning Management System (LMS) Director for Roseman University, now CEO and President of medXForce, suffered what we all hope to avoid in our life: a stroke. In fact, he suffered four strokes. Thomas was always a proactive problem solver and had the attitude of never saying no, of finding solutions no matter how complicated the task. So when Thomas had his strokes, his response, of course, was not to give up—instead he started finding ways to beat it.

After the strokes, Thomas founded medXForce with a mission of helping other stroke survivors. His personal experiences and new friendships with stroke survivors guided him toward creating services to help people with strokes to communicate and rehabilitate.

1. When did you have your strokes?

I had my first stroke in the late afternoon of October 25. Strokes 2-4 came the following day during surgery. It was unexpected for me as I felt good, I was super active, and had fun at work. However, I had smoked for years and years, had a history of migraine attacks, and I had recently had some negative stress, but that had not worried me at the time. I lived a life of a young 44 year old, feeling like a 25 year old in my mind.

2. What was the cause? What were you doing?

medXForce: A New Tool Advancing Communication for Stroke Survivors

By Laura Jarrett

12 Spring/2013

Two weeks before the strokes, I got hit either by another soccer player, or the soccer ball hit me on the left side of my neck. I really did not think much of it at the time, and I still do not know exactly what happened, but I remember not being able to fully move my head side to side. I incorrectly assumed it was a pinched nerve, which seemed like no big deal. It got better, ironically, during another soccer match, and suddenly I was able to move my head again. With my theory of a minor injury confirmed (and healed, so I thought), I didn’t think any more of it.

On October 25 I was on my way to meet up with my kids for a training day. At around 6 pm I had the stroke, and by 7 pm I was at the hospital, though it took a long time to officially diagnose me with a stroke. The next day I was moved to the stroke center of St. Rose Hospital, and things started happening fast. They would not even wait for me to talk to Navi (my girlfriend), which was frustrating because I felt like we had wasted so much time up to this point that a few minutes here or there will not make a difference.

But it took Navi a long time to find me in the hospital, and the doctors would not wait. I guess the clock was ticking for me.

We’ve all seen the advertisements that say “Stroke: Every Minute Counts.” Today I feel like it would have been cool to act earlier and faster, and maybe I wouldn’t be where I am today, but then I think, “Why should I think this way? I can’t change time. It happened and I, we, YOU have to deal with it.” It is time to look forward!

3. Do you remember much during the surgery?

Initially I was awake during the surgery, talking to the surgeon, and then I had a massive brain stem stroke, literally knocking my lights out. I saw the monitors and something moving, then it was just darkness and silence. They announced “Code Blue,” I stopped breathing, and had a heart rate of 4 or so (which doesn’t really count as alive).

My hospital records indicate cardiac arrest, but the doctors and nurses acted quickly to bring me back. I am so thankful for them. The surgery and the rescue took more than 5 hours. Days later I slowly came out of the darkness as a new person, nothing was the same, and nothing will be the same.

My surgeon later explained it to me by saying, “I am very happy that we pushed you off the train tracks so you did not get hit by the coming train, but what we did not see coming was the double decker bus.”

4. What were your biggest challenges while at the hospital?

There are so many challenges for survivors during that time. I am not sure how much I (and my willpower) contributed to win the first challenge: simply surviving. I was told that my age, condition, motivation, strength and the support of others helped me recover well, which many could consider a miracle due to the extent of the strokes.

The next challenge is getting back to a new “normal.” Today I am able to speak, walk, eat, breathe, I started a company, my mind is going at least 180 mph, I am happy, I go

Innovations SPRING 2013 to sleep with a smile and most importantly I am alive and kicking (although not a soccer ball). I learned that around one-third of people with stroke die immediately or shortly after, so I am very lucky to be granted another chance to do good.

I could not breathe, eat or drink for almost 40 days. It’s hard for people to imagine how this feels.

Your brain literally forgets how the sequence of eating and drinking works, and the complicated process of what muscles to use, and when, for swallowing food. Without knowing the process, the risk of getting something in the wrong tube is extremely high, which can be fatal. Not every stroke patient has these issues, but it is a common challenge for brain stem stroke survivors. I had pneumonia as well. One of the most humiliating parts was not being able to take care of myself— not being able to go to the bathroom on your own at 44 can put a serious dent in your self-confidence.

8. Where are you now with your tool?

We started the development of the application and website, the specifications are done and we expect the first prototype in 6-8 weeks. We have also started to create content contracts and sign up partners. Since there’s no income available yet, everybody has a normal day job, and some can only invest a couple hours a week, which makes progress somewhat slow. In order to facilitate future growth, medXForce is the parent group and we are working currently as the Stroke Group.

Despite all this, my real challenge was communication—with doctors, nurses, and loved ones—which was almost impossible.

I was right-side paralyzed and my left arm was tied to the bed so I could not remove the breathing tube. I could not speak, write with my left hand (never did), or use my paralyzed right hand. I was handed a plastic board with printed-on characters, letters and icons to express myself in word and graphics, or at least that’s the idea. It was a welcome medium and it for sure helped to convey basic information, but the effort it requires is tremendous, especially at that stage of recovery.

5. Were there no other tools for you to use at the hospital or rehabilitation centers?

At the time of my stroke none of my friends or family had the means to scan the market for what was available, but I know that the tools at the hospital did not fulfill my needs for effective communication. Many stroke patients face the same challenges, which is why medXForce wants to change the odds with services, tools, and information that can have a measurable impact on the stroke community.

6. When did you start working on this idea of a tool for other stroke survivors?

The idea to create something better than a plastic board with characters came after one horrible night at the hospital. It was time to remove me from the breathing machine, and after protests by Navi the hospital staff decided to do it during the day when I had supervision instead of at night, but for some reason the night before my oxygen amount was lowered. I didn’t know what was happening, I just felt like I was dying because I couldn’t breathe. I was terrified. I had no alarm button (for whatever reason), and my left arm was still tied to the bed so I had no way to make myself heard. I was able to remove the little device from my finger that measures pulse, but it did not trigger the alarm as I had hoped. I wiggled in my bed and slammed the tied up arm against the side railing of the bed, but nothing. Nobody came. I heard music from the other room and thought “I am done.”

I made it through the night and when my family came they gave me the plastic board and I tried to greet them with the news of the night. “I almost died,” I wrote, repeating it three times, because they did not believe it. I realized people in this situation need quick, easy tools for communication and that I would do something about it.

Rehabilitation, outpatient, in-home care, and the usual bumps along the way slowed down the start of medXForce, but eventually with the help of my friend we put the ideas on paper, into presentation material, documents, conference calls, infrastructure, development, and finally created an LLC. Today we have a network of 12-15 people spending time at medXForce.

7. Is this only for stroke patients?

We started out with the idea to help stroke patients, but realized it can be a tool for anyone with limited or no verbal ability. However, because we are privately funded and the day only has 24 hours, we can’t go after each and every possible opportunity for usage of the application right away. We do know medXForce will be a premier mobile communication tool, and once we are established and are able to help thousands of people each year we will venture into new markets, I promise.

9. What will the application do?

The main purpose is to facilitate a patient’s communication with care providers, family, and friends. We took the concept of the plastic board with the characters and icons and moved it to a tablet (Apple or Android, Windows Surface coming soon). Instead of just pointing to characters, letters and icons while others guess the message (which requires the patient to find all letters and point to them in the right order fast enough that someone can decipher the word), the app helps create sentences and uses predefined sentences and icons to speed the process.

10. What’s medXForce’s mission or goal?

The Stroke Group of medXForce aims to be: “A holistic offering of products, services and information related to stroke. Positively impact the life, rehabilitation efforts and re-entrance into society for the patient. Positively impact the work doctors, nurses, friends and family do.”

11. When will this application be available?

We are planning to be live by June 1, 2013. We would have liked to launch sooner, but we want to ensure we have fun with what we are doing, and remain balanced. Everyone’s a volunteer right now, and I am extremely proud and happy on what we achieved so far.

12. How can others help?

Allowing me to voice the needs, my experience and what we want to do with medXForce is fantastic. What an opportunity to do this interview! Thank you! Spreading the word is the next big step so people know about our application and it becomes the first choice for patients and hospitals. Most importantly, care providers and family and friends need to be informed about the technology and how it can help. Anything people can do to get the word out about how beneficial it can be is very helpful.

You can find more information on medXForce at www.medXForce.com.

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The Source: Information Resources

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SPRING 2013

The Source: Information Resources SPRING 2013 As technology changes and improves, more and more people are adopting it, including kids.

Growing up in a world surrounded by technology is entirely new, and we really don’t know how it will affect development and social relationships for kids. While we can’t stop it, we can educate ourselves about what’s out there and how to keep them safe.

There are many “experts” offering opinions on technology and its effects on our children, but the truth is that there are valid arguments from both sides on whether children should have access to it.

Some of the benefits of children having access to technology include: • Parents can track the location of children (either by calling them or utilizing the GPS function on smartphones and other electronic devices) • There are great educational apps to help children learn • Many schools are going digital with homework and interactive assignments • There are a lot of great resources online • Map apps are available in case they get lost • They have instant access to things that can keep kids entertained, including music, movies, and digital print • Parental controls are available However, there are disadvantages as well, including: • Access to inappropriate websites and content • Potential exposure to child predators via social networking and other apps • Mistakes made online often have long-term repercussions (and children have to learn the hard way that once something is posted online—including inappropriate or embarrassing photos, or online bullying—it is difficult to make it disappear) • It can be a negative distraction and keep them from being active • The potential for “sexting” • Older teens are faced with distractions such as texting, talking on the phone, and surfing the web while driving • The expense associated with using minutes or messages as part of a family data/phone plan

Maintaining Control of the Technology If you do choose to give your child a smart phone or tablet, there are a few things to consider. The first is proper parental controls. Most of these devices should have a way to lock down or limit certain functionality, such as blocking websites and making purchases. There are also apps available for purchase (e.g., AVG Family Safety, PhoneSheriff, eBlaster Mobile) that allow parents to monitor and track their child’s activity on the phone. Some even allow parents to assign GPS boundaries and receive alerts when the child has gone outside of them.

Teaching Children Tech Responsibility Writing out a contract with your own terms and conditions with consequences is another idea to teach them responsibility and hold them accountable for their actions. Enforcing and implementing these rules for cell phone use is very important, so your child can develop healthy habits and learn the limits of appropriate technology behavior.

According to a survey by Pew Research Center, in 2010 four out of five teenagers slept with their phone on or by their beds and those who text were 42% more likely to sleep with their phones. When preparing your contract, be clear and concise, for example, “I will not talk or text on the phone past 8:00 PM on a school night” or “I cannot take this to school with me” with the open consequence of “I understand that failure to follow and respect any of these rules can result in the loss of my cell phone for any length of time determined by my parents”. CTIA, a wireless industry group, has prepared a sample contract that can help you get started: http://files.ctia.org/pdf/bsw/ example_of_family_rules.pdf

Should You Give Your Kid a Smartphone?

Parent’s Decision

Many parents today are giving children smartphones and other technology at younger and younger ages. According to Neilsen research as of July 2012, 58% of 13 to 17 year olds have smartphones compared to 36% in July 2011.

Additionally, research shows that 22% of parents are okay with 10-year-olds having their own smartphones. However, there are no hard and fast rules about when it’s okay for a child to have access to these devices. Your child’s development and maturity should be the ultimate decision factors, rather than an arbitrary age from research, peers, friends, or family.

Ultimately it is up to parents to determine whether and when your children are ready for technology. As a parent, it’s important for you to make an effort to educate yourself about how each different technology is used, and the potential dangers and pitfalls so you can help your children learn to use it responsibly. Technology can open up many wonderful opportunities for children, but it can also be dangerous, so just like every other media influence (television, magazines, music), parents need to accept responsibility for helping children integrate it safely into their world.

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The Source: Information Resources SPRING 2013

Online Resources for Oral Health

By Kitti Canepi

According to the U.S. Department of Health and Human Services, oral health is one of 12 Leading Health Indicators (LHI) for healthy people. More on LHI, and a lot more information about oral health in general, is available through the Centers for Disease Control Division of Oral Health website (http://www.cdc.gov/oralhealth/). Here you can read reports on topics such as the prevalence of periodontal disease and disparities in oral health between different populations, plus find a lot of information and research on water fluoridation.

Oral health tips for children are contained in the Brush Up on Healthy Teeth brochure and the many fact sheets available on the site.

Their program for Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers (http://www.cdc.gov/ chronicdisease/resources/publications/AAG/doh.htm) points out that oral diseases, which range from cavities to oral cancer, cause pain and disability for millions of Americans each year, and most oral diseases are preventable.

For more consumer-oriented materials and information, the Dept. of Health and Human Services National Institutes of Health provides a wealth of information on the National Institute of Dental and Craniofacial Research (NIDCR) website (http://www.nidcr.nih.gov/ oralhealth/). Here you can look up reliable information on specific oral health topics such as: • • • • •

Cavities Gum disease Dry mouth TMJ disorders Oral cancer

• Smokeless tobacco • Taste disorders • Plus many other related issues

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If you are dealing with heart disease, diabetes, or HIV/ AIDS the NIDCR website can help you learn which oral health-related problems are commonly associated with these chronic illnesses, and what you can do to mitigate the effects. The site includes videos, publications and quizzes, plus materials are available in both English and Spanish.

The MedlinePlus Dental Health webpage from the National Library of Medicine (http://www.nlm.nih.gov/ medlineplus/dentalhealth.html), is aimed at consumers who need information about what to expect at the dental office, including common procedures such as dental x-rays and treatments, plus tutorials on brushing and flossing, links to clinical trial information and even a cute online game for kids called “MouthPower.”

The website is available not only in English and Spanish, but also Arabic, Bosnian, Chinese, Russian, and Vietnamese.

If you are looking for well-written short articles about a wide variety of oral health related topics, then WebMD’s Oral Care Center is the place for you (http://www. webmd.com/oral-health/default.htm). News and features range from Everyday Habits that Damage Your Teeth or Electric Toothbrushes: Are They for You? to Get the Most Out of Your Dental Visit, and more. WebMD also posts lots of videos, slideshows, and discussions with an expert to help you navigate your way through all the aspects of good oral health.

The Source: Information Resources SPRING 2013

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Feature SPRING 2013

What is an IRB? By: Dr. Kayta Kobayashi

What is an IRB? An Institutional Review Board (IRB) is a committee formed within an institution (for example, a hospital or university) to ensure that research conducted by its employees and affiliates is ethical. The IRB’s primary priority is to protect study subjects (most often patients) from potential harm, and to ensure the protection of their privacy and confidentiality through continual review of research conducted at the institution’s site, or by the institution’s employees at other sites. If an IRB decides that a research project poses significant risk without substantial benefit, it can deny approval or require changes to the study protocol.

Since an IRB is formed within the organization conducting the research, one concern is that members will either be biased, or unable to objectively review cases. To reduce potential bias in its evaluations and protect against this danger, an IRB includes at least one non-scientific community member who is familiar with local culture and attitudes.

The Beginning of the IRB IRBs arose in response to examples of unethical research in history. During World War II, Nazi physicians forced Jewish prisoners to participate in medical trials that often resulted in significant injury or death. Similarly, physicians working for the U.S. Public Health Services (USPHS) conducted a syphilis study on 600 African-American men between 1932 and 1972. During the study, the physicians did not reveal to the men that they had syphilis and withheld the cure, resulting in the spread of syphilis and many unnecessary deaths. While research abuses had occurred prior to this, the scale and frequency of known abuses was increasing.

As a result, a 1966 memo from the USPHS required that funding for new, renewed, or continuing research involving humans would only be awarded to grantees that had a review board in place to ensure that: • Test subjects’ rights were protected • All test subjects had given proper consent • The research had potential medical benefits • The research did not involve unreasonable risks In 1969 the review boards were expanded to include non-scientific members from the community. The 1966 memo laid the groundwork for today’s U.S. federal regulations, which stipulate basic requirements for research, including the requirement for IRB oversight.

The Benefits of Seeking IRB Approval While IRB approval may delay the commencement of research, attaining IRB approval provides several benefits. Besides reassurance that research meets ethical standards, IRB approval may also limit the researchers’ liability for harm that may come to patients during the study. Additionally, many funding sources will only fund IRB-approved projects, and most departments or researchers collaborating on a project will request proof of IRB approval before providing aid or collaboration. IRB approval also facilitates publication, since many journals refuse to publish research findings from a project that was not IRB-approved. Similarly, many professional meetings

do not allow research to be presented if the research did not get IRB approval. Finally, research that has not undergone IRB approval is not qualified for federal funding and may not be used in government applications such as patent applications and new drug applications. With all these benefits, most researchers actively seek IRB approval for their projects.

Applying for IRB Approval While the application process varies significantly between institutions, the following is typical: First, the researcher must provide documentation that he or she has participated in IRB training, including instruction on IRB history, purpose, and intent, ethical principles, federal regulations, informed consent, and protection of patient data. Next the researcher submits a protocol to the IRB that includes, but is not limited to: • The purpose and intent of the project • Research hypotheses • The amount and extent of data collected or retrieved • How the data will be stored and secured • How patient consent is obtained • Where and how data will be disclosed • Plans for publication In describing the project, the researcher must not only delineate all the potential benefits, but also all the potential risks to the patients.

Eventually, the application is reviewed by the IRB. During this review, the IRB carefully evaluates and weighs the potential risks against the potential benefits. While there is no specific rule about how much risk is allowed, IRBs are much less likely to approve a project with substantial risk and minimal benefit compared to a project with substantial risk but also substantial benefit.

The IRB also evaluates the security of patient information. Eventually the committee members vote and the project is approved, denied, conditionally approved if changes are made to the study protocol, or sent back to the researcher for further clarification.

Ongoing IRB Oversight The process does not end with approval. The IRB continually reviews ongoing projects, examining any protocol changes, and the potential benefits and harm to patients these changes present. Additionally, the IRB may require preliminary evaluation of the results with the stipulation that the study be halted early if predetermined safety parameters are exceeded, failure of expected efficacy poses an unacceptable risk to the test subjects, and/or if new safety information comes to light during a study that brings up a previously unknown risk. Therefore, with continuing review and monitoring, the IRB ensures ongoing accountability of research ethics.

As a consumer, it’s important to understand the purpose and structure of IRBs before signing up as a test subject. A patient looking to enroll in a research study would be prudent to inquire about IRB approval. While IRB approval does not mean participating in a study is without risk, verifiable documentation of IRB approval does mean a patient can be reasonably confident that their participation in a study will not put their health, privacy, or confidentiality at undue risk.

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Feature SPRING 2013

The Economics of Employee Education

By Dr. Okeleke Nzeogwu Employee training and education should be high on every employer’s to-do list, since it increases productivity and therefore is a good way to increase corporate performance and profits. However, there are companies out there that hesitate to provide additional education and development at a cost to the employer because of concerns that more educated and qualified employees are more marketable for competitors as well. Despite this risk, employers should consider the long-term benefits to employees’ professional development and career options.

Training for a Competitive Edge At a staff meeting during the sluggish recovery of the early 1990s recession, a dean told over twenty faculty members that his investment and push to increase their credentials and productivity would make them more marketable to other employers and perhaps put the organization at a loss. This comment raised a few eyebrows, then he added that he thought it was also a good strategy to try to retain his best faculty members, so they would not think he was taking their contributions and loyalty for granted.

Training for Competency Compare the university training setting to another story an employee shared with me about his current employer, a Fortune 500 company. The company hired him with minimal college education, gave him adequate training to perform his duties and meet corporate expectations, and then paid him an “efficiency wage”, or salary that he could not earn elsewhere. While he was well qualified for the job he was doing, both he and his employer knew he was not professionally mobile and a layoff from downsizing would present severe financial and professional challenges. Therefore, his layoff survival strategies and his employer control mechanism were predictable.

The “No Training” Argument

The Benefits of Employee Training Programs Some employers are serious about employee training and education, and literature abound with the purported benefits of these investments, including:

• Employee engagement and retention • Improved morale and productivity • Better customer service • Lower operating cost • Culture of collaboration, communication and opportunity • Leadership development • Lawsuit reduction With the ease and availability of online training, more companies are spending money on training and education, with topics that range from customer services to sexual harassment. In addition, researchers can assess the effect on the bottom line and other market metrics. When they see the results, companies are encouraged to spend more on training and the providers of training services tout their efficacy.

Not all companies provide training, some choosing to forego it because of costs, concerns that employer-paid training can lead to more qualified employees who leave the company (and high recruitment costs to replace lost employees), or other complications. This inward (corporate-centered) view of the benefits of employee training and education misses what the outward (employee-centered) view recognizes: the best employees are ones that are marketable and professionally mobile. Yes, some of those employees might leave but if they stay, they are loyal and autonomous in the long-term, providing the creative input that comes from professional independence.

The education and training that creates these types of employees goes beyond a profit focus to creating change-agent professionals, empowered to be global citizens. Even when some of these employees leave, they are more likely to come back or positively refer to their former employers. They are also often the recession-proof employees who would negotiate and allow their employers to make tough decisions in a crisis.

Employers that do not look at the long-term benefits are missing out on an opportunity to have a highly qualified, and often more satisfied, workforce. Only the employee training and education programs that look beyond present challenges and short-term profits will keep America ahead in the global competition.

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I

magine you are a Registered Nurse (RN) starting your morning shift on a Medical Unit. After receiving a status report on your patient, you learn the patient was admitted from the Emergency Department complaining of a worsening cough, chest pain and a fever. The patient has been diagnosed with pneumonia and is to receive his first dose of antibiotics this morning. After introducing yourself to the patient, you complete a physical assessment and administer the antibiotic, and within minutes the patient complains of severe difficulty breathing. His heart is beating rapidly and you hear a high-pitched wheezing sound with every breath. You notice the patient’s lips are turning blue and the tongue is swelling. You hear fear and anxiety in the patient’s voice as he says, “I can’t breathe!”

Hands-On Experience: The All-New Nursing Simulation Lab By: Dr. Brian Oxhorn

This type of condition, known as anaphylaxis, can happen at any time to any patient following medication administration. The RN must respond quickly and accurately in order to prevent a potentially fatal outcome. For Roseman University Bachelor of Science in Nursing (BSN) graduates, this is fortunately not the first time they have provided care to a “patient” with this emergency, having learned how to recognize adverse medication reactions and implement emergency treatment of anaphylaxis in a timely manner through the use of human patient simulation.

The College of Nursing at Roseman University of Health Sciences has long believed in the importance of hands-on learning, and now has completed construction on a new high-fidelity human patient simulation lab to enhance experiential learning at the Henderson, Nevada campus. A similar facility is also available at the South Jordan, Utah campus.

The simulation labs provide students the opportunity to learn the complexities of clinical practice in a safe environment by eliminating the risks involved in working on live patients, so the learning process itself becomes the dominant focus during the experience, rather than needing to focus on saving a real patient’s life. Through the use of simulation scenarios and the SimMan® Essential, SimMom™ and SimNewB® human patient simulators, Roseman nursing students develop and practice clinical reasoning skills in a wide variety of healthcare settings and situations.

The state-of-the-art lab includes digital video and audio recording devices, so students can provide care based on their own judgment without distraction or interruption from faculty, facilitators or other observers. In a typical scenario, students are assigned roles, such as primary nurse, certified nursing assistant, or family member.

The simulation scenarios are digitally recorded and students review them with faculty in a guided debriefing session afterward, allowing an opportunity to critically analyze their actions, reflect upon their own skills, and critique the clinical reasoning of others.

In the future, the College of Nursing plans to use the simulation lab to help students gain some exposure in healthcare practice areas where there are not as many clinical placements available, such as maternal newborn and pediatrics. In addition, Roseman University is working on the development of inter-professional educational experiences to integrate pharmacy, nursing, dental and medical curricula.

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Oral Health and Overall Health: The Link Between Your Mouth and Your Overall Health

Special Report SPRING 2013

For years many people have viewed dental care and general health care as two isolated things, but instead of focusing on oral health care as something separate from your overall health, patients should consider a semi-annual dental cleaning and examination to be just as important as an annual physical in helping you maintain good health.

In 2000, the office of the Surgeon General released a report detailing the crisis of oral health care in America to raise awareness about the lack of proper oral health care and how widespread the problem is, with specific information about the effects of poor oral health on overall health. It was the first ever report on oral health from such a high-ranking government official (there have only been 56 total reports released by the Surgeon General’s office since they began the practice in 1964, and only 19 of those were on topics besides smoking), and a topic singled out as uniquely important for our nation’s overall health.

Chronic Inflammation & Chronic Disease The human mouth is one of the most effective pathways for pathogens and bacteria to get into the body. A typical human mouth has anywhere between 500-1000 different types of bacteria, which are mostly harmless, and with good oral care your body’s natural defenses are able to ward them off. However, they can become harmful for people who do not have good oral health care habits, causing gum disease, infections, and tooth decay.

When harmful pathogens enter your body and the body senses the intrusion, it reacts by sending toxins (called cytokines) to the area through your blood. The toxins attack the pathogen, remove it from your system, and your body begins healing. This system of acute inflammation is an effective way to deal with injury, illness, and intruders on a short-term basis, but can become problematic if it turns into chronic inflammation. With chronic inflammation, the body does not have a one-time inflammatory response to a specific injury. Instead the body is experiencing continual inflammation, so it regularly releases cytokines into the blood, and eventually the beneficial pathogen fighters build up to a dangerous level inside the body. If they remain unchecked, cytokines begin to circulate and damage healthy cells, including blood vessels, organ tissue, joint tissue, and the digestive tract.

With so much bacteria in the mouth, someone who is not practicing proper oral health care habits will suffer from frequent gum disease and tooth decay caused by the bacteria. These chronic conditions lead to inflammation, and eventually to the buildup of harmful levels of pathogen-fighting toxins inside the body. In addition to the potential that these toxins could harm healthy cells, an immune system on continual alert trying to fight off the inflammation and infection in your mouth requires a lot of energy and resources, reducing your body’s ability to effectively fight off other disease.

Studies Link Oral Disease with Other Disease Several studies have been released in recent years that link poor oral health, specifically periodontal disease, to other chronic health conditions, including heart disease, diabetes, obesity, Alzheimer’s, and even cancer.

The incidence of periodontal disease in the U.S. is very high, with millions suffering from chronic inflammation in the mouth. A study released in 2012 by the Centers for Disease Control and Prevention (CDC) and published in the Journal of Dental Research estimated that almost half of the U.S. adult population has mild, moderate, or severe periodontitis, which is the most destructive form of periodontal disease.

That number skyrockets to 70 percent for adults over the age of 65.

By Tracy Hernandez continued on page 26

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When harmful pathogens enter your body and the body senses the intrusion, it reacts by sending toxins (called cytokines) to the area through your blood. The toxins attack the pathogen, remove it from your system, and your body begins healing.

“Things like gingivitis, recession of the gums, tender and bleeding gums, bone loss, and increased number of cavities can all be indicators of a larger systemic problem,” said Dr. Kenneth King, Associate Dean for Patient Care and Clinical Affairs and Associate Professor at Roseman University.

What is Periodontal Disease?

Periodontal disease is a chronic inflammatory disease that attacks the gums and bones in your mouth. There are several different forms of periodontal disease, ranging in severity from mild to very severe. Mild forms of periodontal disease such as gingivitis, identified by red, swollen, or bleeding gums, can often be reversed with daily brushing and flossing as well as regular dental cleanings.

If left untreated, gingivitis can advance to periodontitis. In addition to red, swollen, and bleeding gums, patients with periodontitis will often experience gums that pull away from the teeth, leaving spaces (or “pockets”) that can get infected and inflamed. In this chronic state of inflammation, the body’s immune system desperately tries to attack the infection, and eventually the high levels of toxins in the mouth start to break down the bones and tissues that hold teeth in place. Without treatment, severe periodontitis will often lead to tooth loss, which can in turn affect your ability to speak, chew, swallow, and smile.

Connecting Oral Disease With Overall Health Today, many health care professionals understand the interconnected nature of the

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mouth and body, and more and more care providers are referring patients with chronic illness to see a dental professional.

“Many physicians and dentists today see the need for a holistic approach that combines oral health and overall health,” said Dr. Llewellyn Powell, Director of Primary Dental Care and Associate Professor at Roseman University College of Dental Medicine-South Jordan. “It’s important for patients to also understand how their oral health can affect their whole body health and to seek regular dental care.”

Diabetes One of the strongest links between chronic disease and oral disease is diabetes.

The elevated levels of cytokines in the body due to chronic inflammation caused by periodontal disease can actually lead to insulin resistance, and eventually diabetes. Patients who already suffer from diabetes have a more difficult time controlling their blood sugar when they experience chronic inflammation from periodontal disease, thus exacerbating the diabetes, and those elevated levels of blood sugar create ideal conditions for infection in the body.

This recurring cycle can create many problems for diabetes patients.

“One of the easiest things that you can do to improve your oral health is brush and floss two to three times a day, every day,” said Dr. Powell.

Heart Disease & Stroke The link between gum disease and heart disease is still not fully understood and more studies need to be done to determine the cause and effect relationship, but according to the American Academy of Periodontology, research indicates that periodontal disease does increase the risk of heart disease, and many leading scientists believe inflammation plays a significant role.

Special Report SPRING 2013 In addition, researchers are studying the relationship between stroke and gum disease, particularly how inflammation from periodontal disease may lead to inflammation in the blood vessels, making it more difficult for blood to travel from the heart to the body, and putting you at increased risk for heart attack, blood clots, and stroke.

Other Potential Links to Oral Disease Many chronic conditions have the same risk factors as periodontal disease, which could account for some of the links between these diseases. The Mayo Clinic identifies several other conditions that are potentially linked to, or complicated by, periodontal disease and poor oral health, including some forms of cancer, HIV/AIDS, arthritis, lung conditions such as pneumonia and COPD, Alzheimer’s, low birth weight, osteoporosis, and obesity.

Improving Oral & Overall Health While raising awareness about the issue is good, most experts agree that the next step is to make sure people understand what actions they can take to prevent oral decay and keep their mouths and bodies healthy in the long term.

“One of the easiest things that you can do to improve your oral health is brush and floss two to three times a day, every day,” said Dr. Powell.

Dr. Powell also recommends that you use a soft-bristled toothbrush and toothpaste with fluoride for best results, and spend one to two minutes cleaning all the surfaces of your teeth. Make sure to get the back of your teeth, and brush the tongue and roof of your mouth as well to remove bacteria. Replace your toothbrush every three months to prevent bacteria build-up.

Heart Disease & Stroke The link between gum disease and heart disease is still not fully understood and more studies need to be done to determine the cause and effect relationship, but according to the American Academy of Periodontology, research indicates that periodontal disease does increase the risk of heart disease, and many leading scientists believe inflammation plays a significant role.

Even if you do brush regularly, plaque can still build up and harden to form tartar, which cannot be removed by brushing alone. Go to the dentist at least once a year, or twice a year if possible, to get professional cleaning and preventive care before the bacteria, plaque, and tartar build up to levels that cause inflammation, gum disease, bone degradation, and even tooth loss. Tell your dentist about any pain or changes you notice in your mouth.

Lifestyle changes are also important. Maintaining a healthy weight, and eating a healthy diet consisting of mostly vegetables, fruits, lean protein, nuts, and whole grains, and limiting sugar can also help reduce bacteria in the mouth. Since smoking is the largest risk factor for periodontal disease (according to the 2012 CDC study), quitting smoking is one of the most important things you can do to significantly reduce your risk.

Whether studies prove definitively that oral disease causes or contributes to other chronic health conditions, one thing is certain—the health of your body and your mouth are connected, so taking care of your mouth is a big part of your overall wellness.

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Special Report SPRING 2013

Rocky:

A True Success Story By: Rachael Wadley

28 Spring/2013

Special Report SPRING 2013 Dr. Roberson began Rocky’s procedure by making a silicone impression of his mouth. The impression needs to be made as soon as possible after the infant is born because the cartilage is more moldable. According to Dr. Roberson, “The earlier treatment begins, the better the results will be. Utilizing the infants’ growth is key to success.”

Once the mold was created Rocky’s family saw Dr. Roberson at the Orthodontic Clinic regularly. On the first appointment the NAM was placed in Rocky’s mouth and taped to his face, since it had to remain in his mouth 24 hours a day, switching the tape every four to six hours. In a Seminars in Plastic Surgery article titled “Nasoalveolar Molding from Infants Born with Clefts of the Lip, Alveolus, and Palate,” authored by Drs. Grayson and Maull, weekly visits are required to modify the molding plate to guide the alveolar cleft segments into the desired position. The goal over time is to bring the separation of the lip closer together so that there is minimal scarring and deformation from plastic surgery as the child grows up. While this requires dedication from the medical team, it also requires a lot of time and dedication by the family.

R

ocky Marks first came to the Orthodontic Clinic at Roseman University’s Henderson campus over eight months ago as an infant with a bilateral cleft lip and palate and desperately in need of a Nasoalveolar Molding (NAM), something that very few orthodontists across the nation are trained to do.

The NAM is usually in place for three to five months before the first plastic surgery to close the lip and nose is completed. Rocky had his first surgery in November 2012. Thanks to the dedication of Dr. Roberson and Dr. Menezes and his family, Rocky was able to receive a proper closure of his lip. He completed his second surgery in December. In February, his family reported that he is recovering well and is a joy to everyone who knows him.

Cleft palate and cleft lip occur when the upper lip, the roof of the mouth, or both, do not develop correctly or do not have sufficient tissue, and therefore do not close completely.

They are among the most common birth defects, according to the Mayo Clinic, and make it difficult to eat, speak, hear, and breathe, as well as affect normal facial appearance. While these conditions can be corrected with surgery, traditional surgical methods are often difficult and may not produce the most aesthetically acceptable and comfortable outcome for the patient.

Dr. Barry Grayson and Dr. Deirdre Maull describe NAM as a technique that utilizes wire and acrylic nasal stents attached to an intraoral denture. The appliance is used to mold the nasal cartilages, premaxilla, and alveolar ridges into normal form and position during the neonatal period.

This presurgical management of a cleft infant is intended to reduce severity of the oronasal deformity prior to surgery by expanding the already malleable tissues and cartilage in the area around the nose. According to a September 1999 article in the Cleft PalateCraniofacial Journal, the change in nasal shape achieved through NAM produces less scar tissue and better lip and nasal form once the patient undergoes surgery. Additionally, as the infant grows, his/her adult teeth have a better chance of coming in properly.

There are very few orthodontists in the world who are able to perform the NAM procedure on infants, but Roseman University is lucky to have one on staff in its Orthodontic Clinic, Dr. Glenn Roberson. In February 2011 Dr. Roberson traveled to New York University to be trained by the doctors who designed NAM, including Dr. Grayson, Dr. Larry Brecht, and Dr. Court Cutting. Since Dr. Roberson’s return from his specialized training, Roseman’s Orthodontic Clinic has already treated five infants who were born with cleft lips and palates, Rocky being one of them.

Rocky’s Road to Recovery

OB/GYNs can see if an infant has cleft lip and palate in the second trimester from a 2D ultrasound. Once it is determined the baby will be born with this facial defect the OB/GYN contacts the plastic surgeon. The plastic surgeon verifies the OB/GYNs findings and sets the family up with an orthodontist who is trained in NAMs if one can be found. In Rocky’s case, the plastic surgeon was Dr. Menezes, Head of Craniofacial Surgery, Division of Plastic & Reconstructive Surgery University of Nevada School of Medicine in Southern Nevada. He currently resides at University Medical Center (UMC). Dr. Menezes contacted Dr. Roberson to create Rocky’s NAM.

Southern Nevada’s Craniofacial Team

Although Dr. Roberson’s work with Rocky is done, the child still has a challenging road ahead, and he will need some additional help as he grows up. Fortunately he is not alone—he has access to an amazing Craniofacial Team headed by Lisa Kurtzberg. This team is located at the Southern Nevada Cleft Palate and Craniofacial Clinic, consisting of specialists in the areas of audiology, dentistry, otolaryngology, plastic surgery, orthodontics, oral surgery, pediatrics, social work and speech pathology.

Dr. Roberson, College of Dental Medicine-Henderson Dean Jaleh Pourhamidi, and residents from Roseman University’s AEODO/MBA program are part of this valuable team, volunteering in the clinic the fourth Tuesday of every month. At the clinic, practitioners use an interdisciplinary team approach for assessment, treatment, and follow-ups for children from birth to 18 years of age with craniofacial conditions. Patients are never turned away because of the inability to pay, and there is no cost to the family.

According to American Academy of Otolaryngology, about one in 1,000 babies born in the U.S. have cleft palate/cleft lip. For thousands of Southern Nevada families dealing with this condition, medical professionals like Dr. Roberson, the Craniofacial Team, and the residents at Roseman’s Orthodontic Clinic help them get through it, and deserve recognition for the good that they are doing. Rocky is just one of many children that will have a better life because of the people who helped with his treatment.

Spring/2013 29

30 Spring/2013

Special Report SPRING 2013

By Barbara Wood

A

ccess to affordable, quality orthodontic care (and oral health care in general) is a growing problem in many areas of the Intermountain West region, and one that Dr. Prashanti Bollu would like to address through research and education. Dr. Bollu is the Director of Dental Research and Assistant Professor of Dental Medicine at Roseman University College of Dental Medicine-Henderson. She is an award-winning research professional, recognized as one of the top in her field by Sigma Xi, the Scientific Research Society. Dr. Bollu’s research interests include Cone Beam Computed Tomography (CBCT), biomaterials, orthodontic insurance coverage gaps, and access to orthodontic care.

Dr. Bollu’s interest in research began during dental school, first at a dental school in India then in the U.S. at Boston University School of Dental Medicine. Her passion for research further strengthened while employed at Boston University as she had the opportunity to work with several prominent researchers. Dr. Bollu also has Masters degrees in Health Care Administration and Business Management.

In 2008 she was accepted at Roseman University as a resident in the Advanced Education in Orthodontics and Dentofacial Orthopedics/MBA (AEODO/MBA) program. She eventually became the Research Coordinator, was then promoted to Assistant Professor of Dental Medicine in 2011, and to Director of Research in 2012. She is an ac-

complished national speaker and works as an orthodontist in a couple of Southern Nevada practices, overseeing several hundred orthodontic cases every year.

While improving access to care is one avenue, another important tactic is creating awareness programs to educate parents on preventable causes of malocclusion.

Improving access to orthodontic care is one of Dr. Bollu’s biggest research goals. The U.S. Department of Health and Human Services’ Medical Expenditure Panel Survey indicates that overall only about 43 percent of people in the U.S. have been to the dentist in the past 12 months.

That number varies significantly by income and education level, though, with nearly 60 percent of people with “some college” education visiting the dentist in the past year, compared to only 17 percent of people who report “less than high school” education. Individuals and families with income levels above 400 percent of the federal poverty line are also far more likely to have seen a dentist in the past 12 months (57 percent) than those who are at or below the poverty level (27 percent).

“One such area of great impact,” said Dr. Bollu, “is oral habits such as nail biting, digit sucking, biting on various objects and prolonged use of pacifiers. The duration, frequency and type of habit can cause long-term damage to the teeth and surrounding structures which can require longer and complex treatment solutions. Early prevention can minimize several deleterious effects.”

Part of the reason for this disparity, Dr. Bollu believes, is that many people who really need treatment cannot afford it. Dental and orthodontic care is expensive, and may not be a high priority for a family that has limited disposable income, particularly if that family also does not have dental insurance to help cover the cost.

“Malocclusion, which is any deviation from the normal position of teeth and jaws, increases the risk of gum disease and dental decay. Poor oral health negatively impacts the overall health. Besides, the psychological impact of a crooked smile and poor dental health is often underestimated. It is sad that the decision to seek orthodontic treatment is often dependent on insurance coverage, which is negligible for the vast majority,” said Dr. Bollu.

Improving early prevention strategies is the focus of her newest research project, which she unveiled at the Roseman University Mother/Daughter Tea event on March 9. The project begins with surveys Dr. Bollu created, to be completed by thousands of Southern Nevada parents about the habits that negatively impact children’s oral health. This information can help drive future education initiatives around parents, children, and oral health.

Since many habits are emotionally driven, Dr. Bollu hopes that with enough information and educational awareness on how to deal with them, parents can begin to change these behaviors. In addition, parents can be aware of the need for early oral health care, even for babies and young children whose teeth are not fully formed. Dental problems, like medical issues, are often easier and less expensive to take care of if they are caught and treated early, rather than waiting for then to become an oral health emergency.

If you would like to be included in this survey and help move oral health research forward, e-mail Dr. Bollu at pbollu@roseman.edu.

Spring/2013 31

Special Report SPRING 2012

32 Spring/2013

Special Report SPRING 2013

Utah Dental Clinic

NOW OPEN at Roseman University

By Tracy Hernandez

The Dental Clinic at Roseman University officially opened on February 12, 2013, offering affordable dental care for children, teens, adults, and seniors in and around the Salt Lake valley. Students in the Doctor of Dental Medicine (DMD) program at Roseman University now treat patients as part of their curriculum to become dental professionals.

The clinic provides basic oral health care at a fraction of the usual fees charged for dental procedures.

While prices vary by procedure, fees for services are approximately 25 to 50 percent lower than the average cost.

The second-year DMD students’ academic schedule through August includes two half days per week in the clinic, on Tuesdays and Thursdays from 1 p.m. to 5 p.m.

"A critical component of the DMD curriculum is the opportunity for students to treat patients under the direct supervision of Utah-licensed dentists,” said Dr. William Carroll, Interim Associate Dean for Academic Affairs. “This enables them to make supervised clinical decisions and begin to deliver comprehensive dental care to patients of all ages and backgrounds.”

The Dental Clinic at Roseman University offers a wide array of dental care and patient services. Initially, since DMD students are only in their second year of a four-year program, they will conduct basic treatment and preventive procedures, such as cleanings and simple restorations, while faculty provide more comprehensive care for patients whose needs extend beyond basic treatment. Students will not provide more advanced treatments until they reach the third year of the DMD program, beginning in August.

In addition to teaching fundamental patient care techniques, the goal of the clinic is to prepare students to become competent, compassionate oral health caregivers.

“One of the unique characteristics of our students is that not only are they academically gifted, but they have a sincere desire to do what is best for their patients, for their communities, and for their colleagues,” said Dr. Llewellyn Powell, Director of Primary Dental Care. “During their time in the Dental Clinic, we want to continue to foster their talents as an unselfish and highly ethical group of young men and women.”

The Urgent Care Clinic at Roseman University is still available for individuals who have emergency dental care needs, with care provided by licensed dentist faculty members.

The Dental Clinic at Roseman University 10894 S River Front Pkwy South Jordan, UT 84095 801-878-1200 www.rosemandental.com Dental Clinic Hours (through August 2013) Tuesday, Thursday 1 p.m. – 5 p.m.

Urgent Care Clinic Hours Monday-Friday 8 a.m. – 5 p.m.

Spring/2013 33

Alumni Special News ReportSPRING SPRING 2013 2013

REED HOWE College of Pharmacy Alumnus

By Brenda Griego

Roseman University was founded in 1999 as the Nevada College of Pharmacy (NVCP), enrolling its first class of just 38 Doctor of Pharmacy students at a small campus in the Painters Union Hall in Henderson, Nevada. The University still offers a PharmD at both its Henderson and South Jordan, Utah campuses, and now also includes a College of Dental Medicine, with a Doctor of Dental Medicine (DMD) and Advanced Education in Orthodontics and Dentofacial Orthopedics/MBA (AEODO/MBA) residency; College of Nursing, with a Bachelor of Science in Nursing (BSN) and an Accelerated BSN (ABSN); and an MBA program.

Dr. Reed Howe, Director of Pharmacy for St. Rose Dominican Hopitals San Martín Campus in Southern Nevada and is a graduate of the Class of 2004 (the second enrolled class), recounts his experiences, offers advice to current students, and shares information about his current involvement with the University.

Want more information

Call Brenda Griego

at (702) 968-1619 or visit the Roseman website and click on “Alumni” learn more and update your alumni information.

34 Spring/2013

Alumni News SPRING 2013 1. How did you decide you wanted to become a pharmacist?

After I graduated with a biology degree from the University of Nevada-Reno I was working for the family trucking business and also serving as a pharmacy technician. My stepdad is a pharmacist in a retail setting, and one day I was complaining that I was doing all the work, not the pharmacist. So my stepdad said I should quit complaining and become a pharmacist. I thought, “You’re right, I should become a pharmacist and earn that salary.” I wanted a career in healthcare, so I put in applications to several schools, and started at the Nevada College of Pharmacy (now Roseman University).

2. What made you apply to and then decide to enroll at Roseman (NVCP)?

It was a bit of a gamble. When I toured the Painters Union Hall, I remember thinking, “This would be my school?” But I had faith that it would work out. And the three-year program was very attractive to me, since I had two kids at the time. I wanted to work hard, complete the degree, and start working in the field.

3. Who were your favorite professors and why?

Drs. Coffman and Rosenberg were huge influences on me. They are so smart and really know their stuff. They taught a majority of classes and I learned a lot from them.

I also enjoyed classes by Drs. Lacy and Gonzalez; they were a lot of fun. I learned a lot of very practical things that have helped me in the clinical arena from Dean Wiser.

He was also a physician’s assistant (PA) and he taught us about treating the whole person and how to actively consult with patients.

4. How would you describe your experience as a Roseman/NVCP student?

It was excellent – I had to juggle my family life along with school, since I was married at the time and had two children, but I made school a big part of my life and was able to dive into the experience. I was even class president in my second year (P2). I wasn’t in a fraternity but I was elected into Phi Lambda Sigma national pharmacy leadership society, which got me involved in many different projects. The University then was smaller, so it seemed like one big family. Faculty offices were right next to the classroom in the Painters Union Hall so there was lots of interaction between students and professors. We knew all the faculty well and they loaned us books, played ping pong with us, etc. Because the university was so small and new, we as students felt like we were helping the university to grow – we took ownership in the school.

5. Do you feel you received a strong pharmacy education?

I do! At the time, I questioned whether I was learning everything I’d need. I didn’t know until my P3 year if I was truly being well prepared – that’s when I started competing with students from other schools. And that’s when I found out how good my education had been.

at Roseman, is very different from being an undergrad. It really hit me when I was in my second year that I needed to retain every single bit of the information being presented so I could treat my patients.

7. What advice do you have for future Roseman pharmacy graduates?

I would emphasize that they need to be clinically minded and able to interact professionally with patients and physicians. Pharmacists are expected to know our stuff; we are part of the patient care team along with the physician, and physicians expect a dialogue. And I would say students should learn as much as they can in school, and make the effort to continue to learn and grow throughout their careers.

8. Please tell us about your first job after graduation, and about your current position.

I’ve been with St. Rose since I graduated, since I received a St. Rose scholarship that included a three-year work commitment. I started as a staff pharmacist, and after I had been in that position for about six months, the director pulled me into his office and said he knew I was not going to be happy in that role. So, I began to branch out and helped with decentralizing the hospital pharmacy. I was in the ICU unit for a while, and then went to St. Rose’s new San Martín campus as the director when it opened. I am very lucky to have found my dream job only two and a half years after I graduated!

9. Have you had mentors in the profession who were important to you?

I work closely with Jason Glick, who is Director of Pharmacy Services for St. Rose Hospitals and who also serves on the Board of Trustees at Roseman, and it’s been a great thing – I have learned so much from him. He is an incredible leader. I’m also grateful to Vicki VanMeetren, San Martin’s CEO. Her perspective and leadership have made a huge impact on the hospital. My stepdad too has always taught me and served as a role model. He was one of the best retail pharmacists I knew. People would cross the valley to come to him, and they came to him before they saw their family doctor. He knew his stuff – he took time to counsel his patients and to really get to know his patients. And, I am grateful to my family and four children too for being so supportive and understanding.

10. How do you stay involved with Roseman?

I have played in the annual Golf Tournament that benefits scholarship support, even serving on the tournament planning committee. I’m also on the Gala committee this year, I have served on the Strategic Planning Task Force for the University as a whole, and as a preceptor too for Roseman students, which is a gratifying experience.

11. What can Roseman do to help alumni in their careers and to encourage them to remain connected to their alma mater?

6. What advice do you have for current Roseman students?

Making sure we have some sort of newsletter – it is easier for me since I am still in the Las Vegas valley to know what is going on, but a newsletter would still be helpful.

Be active in your group and take part in as much as you can, for it will all help you when you’re in a pharmacy, a medical office or hospital, or in your own dental practice. And remember that getting your PharmD, or any other professional degree

[Editors Note: Please visit the Alumni section of Roseman’s website and the University’s Facebook pages to update your address and contact information so you receive University communications and keep in touch with the latest news! (www.roseman.edu)] Spring/2013 35

ROSEMAN PEOPLE

October 1, 2012 to Present New Hires & Promotions Caroline Araujo is Clinical Staff for the Orthodontic Clinic of the College of Dental Medicine at the Henderson campus.

Saralyn Barnes is the new Human Resources Coordinator for the South Jordan campus.

Martha Batorski, Ed.D., BS, MS and Parand Mansouri-Rad, MS, BA are Adjunct Faculty for the MBA program.

Dr. Harry Rosenberg

Laura Jarrett

Scott Benjamin, DDS, BS, is Adjunct Faculty-Associate Professor with the College of Dental Medicine at the South Jordan campus.

Daniel Hug, BA, AAS is Help Desk Technician II at the Henderson campus.

Laura Jarrett has been promoted to Information Technology Operations Director at the Henderson campus.

Michael Criddle, DDS, BS is Associate Professor and Clinical Practice Team Leader for the College of Dental Medicine at the South Jordan campus.

Delos Jones, MSN, BSN is Assistant Professor for the College of Nursing at the South Jordan campus.

Lajbanti (Laila) Dey, MBA was hired for the position of Human Resources Associate at the Henderson campus. She previously worked as Admissions Specialist in the College of Nursing.

Linda Doleshal is Clinical Staff at the College of Dental Medicine's Orthodontic Clinic at the Henderson campus.

36 Spring/2013

Shannon Holt, BFA, is Library Assistant at the South Jordan campus.

Derrick Latson was promoted to Help Desk Technician II at the Henderson campus.

Jamie Dinsmore, BA, is Administrative Assistant to the Campus Dean for the College of Pharmacy at the South Jordan campus.

Leslie Murray

Toni Green was hired as Post Doctoral Research Associate in Grant Management at the Henderson campus.

Christopher Butler is Help Desk Technician I at the South Jordan campus.

Christine Daoust, ME, BS Human Ecology, BS Art Education, is Assistant Director of Student Services at the South Jordan campus.

Meredith McKenna

for the College of Dental Medicine at the South Jordan campus.

Pamela Gentile, DDS, BS and Burke Soffe, DMD, BA, AA are Assistant Professors

Danielle Marble, BS is Recruitment, Admissions and Enrollment Specialist for the College of Nursing at the South Jordan campus.

Zachary Roberts, BA is Library Assistant at the Henderson campus.

Nena Schvaneveldt was promoted from Library Assistant to Library Associate at the South Jordan campus.

David Smith, BBA is Help Desk Technician II at the Henderson campus.

Marian Tam Vo, AS, BS is Project Coordinator for Technology Services, based at the Henderson campus.

Charles Von Urff, PhD, MS, BEE is Adjunct Faculty for the MBA program at the Henderson campus.

Awards, Recognition and Appointments For the second year in a row, Roseman University of Health Sciences has been named "Best Place to Work" in the medium-sized organization category by the Southern Nevada Human Resources Association. The award was presented at a luncheon event in October 2012. Ben Wills, Director of Human Resources, accepted the award on behalf of the University.

Dr. Harry Rosenberg, President Emeritus and CoFounder, and Dr. Glen Roberson, Assistant Professor of Dental Medicine and Orthodontic Clinic Director, and Dr. Oscar Goodman, Jr., Adjunct Faculty and Researcher, were named Health Care Headliners by VEGAS INC. This is the 7th year that VEGAS INC has presented Health Care Headliners Awards. Dr. Rosenberg was honored for the Lifetime Achievement award, Dr. Roberson was honored for the Dentistry award, and Dr. Oscar Goodman, Jr. was honored for the Research/Scientist award.

Laura Jarrett, Information Technology Operations Director, obtained a Healthcare IT Technician Certification. The certification confirms knowledge and skills required to implement, deploy, and support healthcare IT systems in various clinical settings, including regulatory requirements, organizational behavior, IT operations, medical business operations and security. She also earned Social Media Security Professional (SMSP) certification. The SMSP certification designates professionals with demonstrated knowledge of the technical composition of social networking platforms and skills to effectively mitigate risks in order to safeguard organizations' critical information from social media hackers."

Tam Vo, Project Coordinator for Technology Services obtained her A+ certification.

College of Nursing-South Jordan graduates from the Class of 2012 who took the NCLEX-RN exam achieved a 100 percent first-time pass rate. Since the BSN program began at the South Jordan campus, both graduating classes (2011 and 2012) have achieved this distinction.

College of Nursing-Henderson graduates from the Class of 2012B who took the NCLEX-RN exam achieved a 100 percent first-time pass rate. This is the first BSN class from the campus to accomplish this.

Roseman University College of Dental Medicine DMD students Meredith McKenna and Leslie Murray were elected to national office at the Annual Session of the Student Professionalism & Ethics Association in Dentistry (SPEA). Meredith McKenna was elected as the representative for Regency 1 (West Coast membership region), and Leslie Murray was elected Speaker of the House.

The National Association of Chain Drug Stores Foundation has named P2 student pharmacist Delaram "Della" Bahmandar of the Henderson campus as a 2012 recipient of the Teva Pharmaceuticals Robert J. Bolger Scholarship in the amount of $5,000. In its notification, the foundation stated that out of the many scholarship applicants from across the nation, the Scholarship Committee found Della's achievements to be in the top tier of all the pharmacy students who applied, and they applaud her efforts both inside and outside of school.

Dr. Christina M. Madison, Assistant Professor of Pharmacy Practice, has been appointed as the 2013 President of the Nevada Public Health Association. Including Dr. Madison, there are eight individuals on the 2013 NPHA Board of Directors. The Board is a diverse group of health professionals that focus their energies on fostering collaboration between organizations. Dr. Madison is one of two pharmacists in the country to lead a public health organization.

Jason Roth, Vice President of Communications, has been invited to join up to 14 business, corporate and community leaders for the exclusive Drug Enforcement Administration (DEA), Las Vegas District Office, Citizen's Academy. To increase public awareness of the DEA, the Academy offers participants a rare look inside the nation's top drug law enforcement agency to foster detailed understanding of the intricacies involved in global drug law enforcement. This spring, Roth attended lectures as well as various activities outside of the classroom, including training and presentations related to firearms, surveillance, and enforcement tactics. Dr. Paul Oesterman was invited to participate in the Citizen's Academy in 2012.

Spring/2013 37

ROSEMAN PEOPLE

October 1, 2012 to Present Research, Publications and Presentations

Barbara Wood

Dr. Jene Hurlbut

Dr. Ronald Fiscus

Dr. DeSchepper

Awards, Recognition and Appointments

Delaram "Della" Bahmandar

Jason Han

Dr. Robert Passamano (AEODO/MBA Class of 2012) had submitted one of his residency orthodontic cases to the Align Technology's University Challenge Program. He placed second in the competition and as a result Align Technology has given the Program a $2,500 donation to go towards resident scholarships.

For the third consecutive year a resident of the AEODO/MBA program has been selected to be a participant in the Charley Schultz Resident Scholar Award competition. Dr. Nahal Niknam, Class of 2013, presented a poster at the 2013 AAO Annual session in Philadelphia, after her project received several positive reviews from AAO members who took part in a survey. Dr. Niknam also received a cash award for being selected as a participant.

Barbara Wood was elected to the Board of the Las Vegas Railroad Society.

Kiya Mohadjer

38 Spring/2013

Dr. Adam McCormick, Assistant Professor and Director of the Oral and Maxillofacial Surgery (OMFS) unit at the College of Dental Medicine in South Jordan, recently became a board-certified oral and maxillofacial surgeon. Becoming board certified is an extensive process. First a person must graduate from an accredited

OMFS program, then pass an extensive written exam (which cannot be taken within the first six months following graduation). After passing the written exam, the person can sit for the oral boards, offered every February in Dallas, TX. It's a four-hour oral exam with eight different examiners asking questions about four different topic areas.

Nevada campus P3s Jason Han and Kiya Mohadjer placed in the Top 10 during the ASHP Clinical Skills Competition (CSC), during the ASHP Midyear Meeting in Las Vegas. This was the third year in a row that Roseman has had a Top 10 finish at Nationals, competing against more than 120 other Colleges of Pharmacy. The placement earned them access to ASHP's PharmPrep Online, a case-based board preparatory tool, and an iPod Touch preloaded with a oneyear subscription to Lexi-Complete™ with AHFS Essentials™. The CSC is an interactive, team-based analysis of clinical scenarios for hospital/health-system pharmacists, which provides pharmacy students the opportunity to enhance their skills in collaborative practice with physicians in providing direct patient care.

Faculty Research, Publications and Presentations Dr. Venkata Kashyap Yellepeddi, Assistant Professor of Pharmaceutical Sciences in South Jordan, received a 2012-2013 American Association of Colleges of Pharmacy New Investigator Award. The $10,000 award is for his proposal "Omega 3 Fatty Acid Conjugated Nanoconstructs for Targeted Delivery of Paclitaxel." Dr. Yellepeddi is the first faculty member from Roseman University to receive this highly competitive award, which is given to a faculty member starting his/her academic career at U.S. colleges and schools of pharmacy accredited by ACPE. Each year around 250 pharmacy faculty members compete for only 18 awards.

Dr. Yellepeddi was also awarded a grant from the International Academy of Compounding Pharmacists Foundation (IACP). The grant was awarded due to Dr. Yellepeddi's research study on the "Formulation and Stability Studies of a Preservative Free Prochlorperazine Nasal Spray for Pain Relief in Migraine."

Dr. Jene Hurlbut, Associate Professor of Nursing, and Betty Ann Powers-Luhn, Adjunct Faculty for the College of Nursing at the Henderson campus, were accepted to present a podium presentation at the National Association of Community Health Nurse Educators & the American Public Health Nurse Association Joint Meeting in Raleigh, NC in June.

Their abstract is titled "Community Collaborations with Alternative Clinical Sites that Provide Services to

Marginalized Populations."

Dr. Edward DeSchepper, Professor and Director of Clinical Foundations at the College of Dental Medicine in South Jordan, was published in MedEdPORTAL. His curriculum, "Dental Anatomy for the Medical Practitioner," passed the peer-reviewed process and is now available on the MedEdPORTAL website for health care practitioners and educators to utilize. The curriculum is designed for medical school students and faculty, nursing school students and faculty, nurse practitioners, and other healthcare professionals who would like to be better prepared to conduct basic oral health examinations and identify potential oral health issues. In addition to increasing inter-professional educational models at health care universities, it could also be used to educate current physicians and health care workers. The curriculum can be found at www.mededportal. org/publication/9303.

Dr. Adam McCormick had a paper published in the March 2013 issue of the Journal of Oral and Maxillofacial Surgery, titled "Reducing the Burden of Dental Patients on the Busy Hospital Emergency Department."

Mary G. Johlfs and Dr. Ronald R. Fiscus research “Protein kinase G type-Iα directly phosphorylates cSrc at serine-17, promotes cell attachment and proliferation and suppresses cisplatin-induced apoptosis in human NCI-H23 non-small cell lung cancer cells” was accepted with minor revisions by Cell Communica-

tions and Signaling for publication in April 2013.

The American Dental Education Association (ADEA) chapter at Roseman's South Jordan Campus was recognized with two awards at the ADEA Annual Session in Seattle: Distinguished Chapter Award and Most Improved Chapter. Chapter leaders from all over the country were very impressed with what the College of Dental Medicine has been able to do in the past two years.

Two DMD students are representing Roseman's College of Dental Medicine-South Jordan with national ADEA leadership positions this year, serving schools in CA, WA, OR, AZ, NV and UT. Cameron Reese is the ADEA Policy Center Liaison for Governmental Relations and Advocacy, and Meredith Dugoni is ADEA Pacific Regional Representative.

Three DMD students are representing Roseman University with leadership positions as District Chairs for District 10 in the American Student Dental Association (ASDA). Phillip Wong is the new District Newsletter Editor, Meredith Dugoni is Community Outreach Coordinator, and Kedy Shen is District Social Chair.

Roseman University's ASDA President reported that "competition was stiff for these positions," with Roseman DMD students winning three of five District Chair positions over members from other ASDA chapters at dental schools in Oregon, Washington, Nevada, and Arizona.

Spring/2013 39

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