Remedy Magazine - Summer 2016 by Roseman University of Health Sciences

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remEDy Roseman University of Health Sciences

Summer 2016 | Publishing Semiannually | Volume 5, Issue 2

INSIDE:

Special Report On Aging

ABC's of Medicare remEDy Summer 2016 | 1

n a July 2013 article in the Wall Street Journal, author Ron Winslow highlighted the fact that while the average life expectancy of Americans is longer than it has ever been, that does not necessarily mean that the extra years we live are quality years. Death rates overall have gone down (adjusted for age), but the rates of neurological conditions like Alzheimer’s disease and illnesses associated with obesity are simultaneously on the rise. In addition, according to Winslow’s article, the number of years that a person lives with a chronic disease or disability has been going up. What that data indicates is that while we have succeeded at prolonging the total time that a person is alive, people are not necessarily getting any more quality years in that longer life. The data comes from a study published by JAMA, the Journal of the American Medical Association, along with reports on physical activity and obesity across the U.S. Part of the increase in disease could perhaps be attributed to an aging population—in 2013 people age 65 and over accounted for 14.1 percent of the U.S. population (44.7 million people), a significant increase from 50 years ago when they made up about 6 percent of the population—and the current 65+ population is projected to more than double to 98 million by 2060. This increase presents key challenges to an already taxed healthcare system, and will require the efforts of everyone from healthcare providers and institutions to individuals to ensure that as people age they are able to access the care they need to not only live longer, but to live well during those years. We have made significant strides in treating chronic conditions such as cardiovascular disease and some cancers, but there are still significant challenges that we must address. Poor dietary habits, for example, have become the most significant risk factor for disability or premature death (overtaking smoking); other risk factors include not getting enough exercise or physical activity, and not managing stress or addressing emotional well-being. Healthcare providers today are thus not only working to increase access to quality care, but to help individuals understand the role they can play in their own healthcare. Unfortunately there is no magic pill to help us all live longer and healthier, but that doesn’t mean it’s completely out of our control. There are many small things we can do that will help us age successfully, which is why we decided to dedicate this issue of remEDy to the topic of Successful Aging. We hope you can find some useful information that will help you live out your “golden years” as well as possible.

Tracy Hernandez, Editor

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TABLE of CONTENTS THRIVE Managing Medications Through Technology

Brain Training & Your Memory – Does It Really Make A Difference?

Taking Care Of You While Caring For Aging Relatives

LEARN Finding Help As You Get Older

Online Resources For Older Adults

INNOVATE The Six-Point Mastery Learning Model Story

EXPLORE

(A SPECIAL REPORT ON AGING)

What Is Successful Aging & Why Is It Important?

The Importance Of Palliative Care

ABC's Of Medicare 20 Oral Health Changes In The Aging Population

DISCOVER Reinvention: Making A Change In Your Mid-To Late Career

remEDy Summer 2016 EDITOR Tracy Hernandez ASSISTANT EDITOR Jason Roth COPY EDITOR Rachael Wadley ART DIRECTOR Eric Jones EDITORIAL BOARD/ CONTRIBUTORS Dr. Doug Ashman Kitti Canepi Dr. Kara Clapp Brenda Griego Dr. Deb Hedderly Shatana Nixon Chrissy Rose

GUEST CONTRIBUTORS Cathryn Barber Debbie Beckstrom Rebecca Dukes Clarissa Gregory Lindsay Hammeren Kristie Holbrook Laura Jarrett Vanessa Maniago Salwa Naim Dr. Catherine Oswald Agafe Saguros Brian Sodoma PHOTOGRAPHERS Loretta Campbell Francia Garcia Chase Schmidt Cameron Haymond Canico Studios

Preventing a Fall 26 Making A Difference One Brown Bag Medication Check-up At A Time

Roseman University Expands College Of Nursing Offerings

RECOGNIZE

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 at remedymag@roseman.edu 702.968.1633 | 801.878.1035

Charitable Gift Annuities: Give While You Receive

Roseman Dental Student Chosen As Winner of National Research Event

Alumni Spotlight – Jeffrey McMillan

MBA Program NV 702.968.2015 | UT 801.878.1111

Student Advocacy & Legislative Day Conference

2nd Annual Research Symposium Highlights

College of Pharmacy NV 702.968.2007 | UT 801.878.1053

Roseman NCPA In South Jordan Raises Money For Utah Refugees

College of Dental Medicine NV 702.968.5222 | UT 801.878.1400

College of Nursing NV 702.968.2075 | UT 801.878.1062 College of Medicine NV 702.802.2852

OUR PEOPLE 41 remEDy Summer 2016 | 3

THRIVE

rrett By Laura Ja

Managing your medications can be difficult, especially for those taking multiple prescriptions at various times of the day or week. However, neglecting to take your medicine can impact your progress on treatments and can be very harmful. A 2013 medication adherence presentation from the Centers for Disease Controll (CDC) stated that non-adherence causes 30 to 50 percent of treatment failures and as many as 125,000 deaths annually. There are several options to help with taking your medications, including hardware built to dispense and organize your prescriptions and the old-fashioned prescription diaries, but technology is making it much easier to track these tasks with a handheld device you likely keep with you at all times—your smartphone.

All are available in the app stores for both Apple and Android devices. Some are free while others have a cost, so it’s always recommended to review the ratings and the descriptions of the products before you pay for them and install them on your devices.

As far as apps, there are a lot to choose from. Your specific needs will help determine which app is going to work best for you. If you just need a reminder, for example, you can use the built-in alarms on your devices. However, if you are looking for more compliance management, there are apps that will track times, doses, refill reminders, your pharmacy’s contact information, as well as the ability to include notes, such as “must take with food.”

For those who require more assistance with managing medications, there are electronic pill boxes that remind you to take your prescriptions using visual and audio cues, such as blinking lights and alarms. If you forget to take your pills, you can set up a system where you and your caregiver get an email, text, or even receive a phone call. For added safety, some electronic pill boxes can restrict you from opening boxes if it’s not time to take those specific pills. Depending on the functionality required, monthly fees may be associated with these as some require you to have a cellular data plan tied to them. Others use wireless technology and may just have one-time costs.

Another advantage for tracking your medications through an app is the ability to effectively communicate your prescriptions (including prescriptions, over-the-counter medications, supplements, and vitamins) with your doctor — exactly what you’re taking, when you started, and how long you’ve been taking them. We’ve all been there: the doctor asks what we are taking and we forget what it’s called or how much we take. We might remember what it starts with or even sounds like, but it’s best if you know the exact name and dose. Tracking will eliminate that from happening, and can go even further to identify medications you’ve had allergic reactions to in the past as well. Some popular medication management apps include: My Medications

Medisafe

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Dosecast

Mediware

Some electronic pill management devices include: • MedMinder • MedFolio • Alert1 • e-Pill Whether you need a simple reminder to take your pills or something more robust for managing your medication, the technology is widely available and easy to use for people of all ages.

Brain Training

Your Memory Does It Really Make A Difference? By Chrissy Rose

If there was something you could easily do every day to protect and improve your memories and intellect, would you do it? The answer for most of us is yes, which is why brain training has become all the rage in recent years. Lumosity and other brain training programs, such as Cogmed and BrainHQ, imply that by utilizing these resources, you can become smarter, increase your memory, and deter the onset of Alzheimer’s and other diseases marked by cognitive decline. With claims like the one on Brain HQ’s website that say its exercises have been “proven in dozens of published studies to make real and lasting improvements in brain function,” it’s easy to see why so many people are signing up for the services. Brain HQ isn’t the only one either—Cogmed claims that their games are scientifically proven to improve your attention and increase working memory capacity.

In fact, the claims of these brain training websites have come to be seen as false advertising by many, from the consumer who pays at least $20 per month to play the games to the scientific community that studies the brain. In January the Federal Trade Commission cracked down on the most well-known of these brain training companies, Lumosity, because its claims about improving cognition and preventing Alzheimer’s were not backed up by credible science. Since this crackdown, the CEO of Lumos Labs (which makes Lumosity games) has publicly acknowledged that these original claims have never been scientifically proven or supported.

The reality is that many of these claims have very little scientific support. Although brain-teasing games may improve your ability to solve those particular tasks, this improvement does not necessarily translate to an improved ability to think about and solve other problems unrelated to the games.

Although online or similar brain-training games may not be the singular answer to reducing the chances of developing diseases such as Alzheimer’s, that does not mean that they are necessarily a bad thing. Many experts on aging agree that learning new skills and participating in activities that challenge your brain can help maintain better cognitive function as you age, and when they are combined with other activities such as physical exercise, maintaining an active social life, and eating a healthy diet, these games certainly won’t hurt anything.

Numerous studies have been done in an attempt to corroborate the claims of brain-training companies, but none have been able to show that practicing online games translates to a real and measurable improvement in cognition. Those few studies that do happen to support the claims of Cogmed and others are often dismissed as sloppy or clearly influenced by scientists working for a brain-training company who might have an incentive to find positive results.

The key is to recognize that brain-training activities alone are probably not enough to stave off age-related memory loss or cognitive decline. If you’re worried about these things, talk to your healthcare provider about your concerns and discuss options that can help you maintain optimal cognitive health for as long as possible.

thrive

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TAKING CARE r o f g n i r a C e l i h W OF YOU Aging Relatives By Tracy Hernandez

It is one of the greatest role reversals of our lives, but for many people it is an inevitable part of getting older – parents who once cared for their children will eventually get to the point that they will be the ones in need of care, and often it falls to their adult children to take over that task. For Katherine McCraley, a faculty member at the College of Dental Medicine at Roseman University, it happened very suddenly. McCraley’s mother was visiting from Colombia last June when she suffered a stroke. She spent four days in the intensive care unit and then returned to McCraley’s house, where she still lives today; she needs constant care because a congenital heart condition prevents her from going back to Colombia. In fact, doctors were surprised that she was able to make it to the U.S., saying most people with this condition would not have survived the three flights she took to get here. She has a heart condition (present since birth, but something she knew few details about) where blood does not pass through the chambers properly to gather oxygen from the lungs before it goes back out into her body. That lack of oxygen in her blood eventually led to her stroke. “She hates [being on oxygen],” said McCraley. “Plus because of the stroke she lost part of her vision. One of her eyes is totally blind, and the other got worse after her second stroke in January.” McCraley’s mom also speaks only Spanish and has to stay at home alone during the day while her daughter is at work. McCraley is able to come home at lunch most days, but occasionally has to prepare things in advance for the whole day, leave it for her, and hope her mother remembers to take her medication and eat the meals.

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As adults age, safety, nutrition, and independence are the biggest challenges, says Dr. Lisa Rosenberg, who recently presented on this topic at Roseman University’s Neighborhood Health Series in Summerlin, NV. This is especially true for older adults who are still living on their own. “Safety is a really big deal, so for older adults who may be getting forgetful; that is not to say they are developing dementia, but it’s really important for friends and loved ones to know they are turning off the stove at night, locking the doors at night, [that they have] a CO detector, and a smoke detector,” said Rosenberg. In addition, family members need to make sure they are taking their medications properly and eating nutritious meals.

For older adults who are not able to live on their own, there might still be ways to help them maintain some dignity and independence, says Rosenberg. Caregivers and adult children can allow them to do the things they are able to do. McCraley’s mom, for example, is able to take care of her personal care needs such as bathing and getting dressed each morning, but needs help with meal preparation, organizing medications, and checking oxygen levels in her tank. The most stressful part, says McCraley, is not the physical care, but the emotional toll it takes on the whole family. Her mother has become depressed lately and talks about wanting to go back to Colombia, believing everything would be better if she went home. The problem is that she would be unable to care for herself, she has no family left in Colombia, and she would likely not survive the trip home. “It’s my job, it’s my primary job to take care of her. It takes up as much time as a regular job,” said McCraley, who also has to juggle full-time employment as an Auxiliary Dentist at Roseman University, as well as caring for her own two children, ages 14 and 11, as a single mother. “I think it is hard for them to understand why everything is different and adapt to the situation too.” McCraley is certainly not alone. In the U.S. today there are about 44 million adults caring for aging parents, family members, or friends. Beyond simply taking up time, caregiving can take a toll emotionally—depression among female caregivers is twice as common as their non-caregiver counterparts—and financially, since caregiving families on average make about 15 percent less than non-caregiving families.

Migration, economic opportunity, and other factors have also increased the distance between parents and adult children, which can make it even more difficult, according to Rosenberg. Associate Professor at Roseman University College of Dental Medicine Dr. George Richards was living in Utah when his father, who lived in Ohio at the time, suffered a stroke. While at the hospital getting treatment, it was discovered he also had endocarditis. Richards’ dad ended up coming to live with him and his wife, and while he was grateful that he was able to spend time with his dad and provide for his needs, the sudden change of schedule was challenging. “I had several things going, besides my [dental] practice I was also really involved in [my] church, and I was gone quite a bit of time, but it required that I make time for him,” said Richards. “There were certain times I had to be there, for example, one of his IVs was at 5:00 in the morning, the other was at 4:00 in the afternoon, so I had to rearrange my schedule to meet his schedule. I was certainly willing to do it.” What does help, says McCraley, is being as organized as possible. It was hard at the beginning, but setting a routine each day has made it easier. Organizing her mom’s pills so she takes the correct ones at the right time, preparing meals, and scheduling appointments well in advance with doctors and hospitals has helped to create a routine for everyone. “To be honest, I do get overwhelmed sometimes,” said McCraley. With a son on the basketball team, a daughter in violin lessons, school projects, and commitments at church, there’s not a lot of extra time in the day. Recently when she came home at the end of the day on a Tuesday (the day she cannot go home at lunch) she discovered that her mom had not eaten anything since breakfast. “I was very upset that she didn’t eat, and I made her get out of bed to come and have some dinner. She called me ‘The General’ because I command too much,” McCraley said with a laugh. “I was so tired, and finally said to everyone, ‘you need to cooperate with me because I feel like I can’t do everything myself ’. ” “This is the hardest job in the world,” said Rosenberg. “The hardest job in the world is taking care of someone whose needs are increasing.” People caring for aging family and friends often suffer from isolation, self-neglect, feeling resentful or unappreciated, and depression, she added. That’s why it’s so important to build a network of support, whether that means spending time with friends or colleagues who are separate from your role as a caregiver, or joining a support group of other caregivers. McCraley makes sure to take time for herself, going to the movies a couple times a month or going outside for a hike when she feels like she needs to recharge. “Everybody demands my time, but I stop and say, ‘I need some time for myself, bye-bye’ and I go do something for me,” said McCraley.

thrive

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REthink C O L L A B O R AT I O N

Collaboration today isn’t just vertical, it’s horizontal, even diagonal. Today’s most qualified healthcare practitioners work across and between disciplines, so that the patient receives the very best treatment and can expect the best outcomes. Roseman University of Health Sciences has been rethinking collaboration since our inception in 1999. Using the Six-Point Mastery Learning Model we train a different kind of student to thrive and practice in today’s complex world of medicine and patient care. Challenge. Rethink. Roseman. Learn more at roseman.edu

COLLEGE OF DENTAL MEDICINE COLLEGE OF NURSING

COLLEGE OF MEDICINE

COLLEGE OF PHARMACY

MASTER OF BUSINESS ADMINISTRATION

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@rosemanuhs

LEARN

Finding Help

As You Get Older By Clarissa Gregory

There’s not much use denying the truth: getting older can be tough. Aging brings with it a lot of challenges, including health challenges, mobility challenges, and difficulty with some of the tasks that might have been easy for you in your younger days. The bad news is that nobody has discovered the “magic pill” to make you young again, but the good news is that there are many services available to help meet your needs as you age. Whether it’s help with meals or rides to doctor appointments, or you just need someone to shovel the snow off your driveway, these programs can help.

Transportation Needs The Rides for Wellness Program in Salt Lake provides transportation for adults, 60 years of age or older, with no other means of transportation to medical appointments and prescription pick-ups within Salt Lake County. To enroll as a new client, call 385-468-3200.

Nutritional Needs The Meals on Wheels program delivers meals to homebound adults (60 years of age and older) who are unable to prepare their own meals and don’t have family or other resources to help with meal preparation. To see if you or a loved one qualify for this service, call 385-468-3200 in Salt Lake, Utah or 702-385-5284 in Clark County, Nev.

Legal Aid The Senior Law Project of Salt Lake County uses volunteer attorneys to help with problems related to wills and estates. For further information regarding these legal programs you may contact 801-328-8891 or visit www.utahlegalservices.org.

The Utah Commodity Supplemental Food Program (CSFP) provides adults living in Utah a monthly food box containing 10 days’ worth of nutrient-rich foods. To qualify for the program you must be 60 years of age or older, and have an annual income at or below 130 percent of federal poverty guidelines (for a single-person household that is $15,444 and for a two-person household it is $20,826 in 2016). Interested adults must fill out an application and be approved to receive a food box. To complete an application visit www.utahfoodbank.org/csfp-application-process, and call 801-887-1275 with any questions.

The Senior Ride Program in Clark County provides discount taxi coupons to adults 60 years of age or older for necessary trips. For more information, call 702-486-3581.

The Senior Citizens Law Project provides legal counsel and assistance to qualifying Clark County residents age 60 and older at no charge. Assistance may include simple wills, advanced directives, powers of attorney and guardianship. For further information call 702-229-6596. Snow Removal or Yard Care The Information and Assistance Program connects adults over 60 in Salt Lake County to services and resources to help with independent living, including snow removal and lawn mowing. To be eligible for yard care, adults must be unable to shovel their walk or mow their own lawn and no able-bodied individuals can be living in the home. Call 385-468-3200 to find out more. Many programs are available to help meet the needs of senior citizens throughout Salt Lake and Clark County. For more information about other programs available to aging adults contact Salt Lake County Adult and Aging Services at 385-468-3200 or visit slco.org/aging-adult-services/, or in Nevada, contact Clark County Senior Advocate Program at 702-455-7051.

learn

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sa Gregory

By Kitti Canepi and Claris

You were just told you have high blood pressure and want to learn more. Or maybe you would like to learn more about an exercise program created with seniors in mind. You know the information is out there, but youâ&#x20AC;&#x2122;re just not sure where to look. Well, youâ&#x20AC;&#x2122;re in luck. There are many resources available to learn more about your health including websites and health education classes. 10 | remEDy Summer 2016

The Older Americans Act, in effect since Oct. 1, 1965 and modified several times over the past 50 years, has provided a national network of aging services and funding that helps older adults with everything from home-delivered meals and preventive health services to transportation, job training, caregiver services, and elder abuse prevention. If you’re not sure where to start to find out about all these services and programs, the following websites provide some great information and links.

NIH Senior Health nihseniorhealth.gov This website discusses a variety of topics including commonly occurring conditions and diseases such as: • Diabetes • Parkinson’s disease • Bones and joint health • Tips for healthy aging • Memory and mental health • Vision and hearing changes.

services in their area, as well as learn about various state regulations, licensing requirements, state contacts, and other home healthcare information. Home care companies are listed by city and state, and the website also lists a range of skilled medical services such as nursing care, physical therapy and occupational therapy from qualified medical professionals in addition to various services from home health aides. Other home care companies might offer assistance with daily activities, such as bathing and eating.

Care Innovations www.careinnovations.com Intel-GE Care Innovations® provides turnkey remote care solutions. Health Harmony enables the collection and transmittal of daily biometric data, collection of health assessment information, and monitors changes in existing health patterns. Patients, caregivers and family members also have access to clinician-directed health sessions, videoconferencing, and interactive education to help keep all parties engaged. QuietCare® smart sensor technology uses motion sensors to collect and interpret billions of patient data points that measure and interpret activities of daily living in order to provide the most accurate and up-to-date picture of patient care. The predictive algorithms lead to improved response times, identification of potential problems before they become urgent situations, and earlier intervention points.

In addition to many easy-to-read articles (font size and contrast can easily be adjusted to make reading easier), this website also has dozens of short videos for those who have vision impairment.

National Council on Aging www.ncoa.org The National Council on Aging partners with nonprofit organizations, government, and businesses to provide innovative community programs and services, online help, and advocacy to help people aged 60 and up meet the challenges of aging. Their website includes online tools to: • Check eligibility for benefits to help pay for food, medicine, rent or other daily expenses • Get tips and resources for budget management, saving money, avoiding scams, finding a job, and more • Explore how to make the most of Medicare benefits and find the best plan.

Home Health Care Agencies www.homehealthcareagencies.com HomeHealthCareAgencies.com was created to give consumers a resource where they can research Medicare-certified home care agencies, private duty home care companies and hospice care

National Adult Protective Services Association www.napsa-now.org The National Adult Protective Services Association (NAPSA) is a non-profit organization with members in all 50 states that provides Adult Protective Services (APS) programs a forum for sharing information and improving the quality of services for victims of elder and vulnerable adult mistreatment or abuse. APS workers frequently serve as first responders in cases of abuse, neglect or exploitation, working closely with a wide variety of allied professionals such as physicians, nurses, paramedics, firefighters and law enforcement officers. An interactive online map helps people find APS agencies in their area. Health Education Classes Many states and counties also offer a variety of classes and workshops for adults. Salt Lake County Aging and Adult Services’ Active Aging Program, for example, provides classes at senior centers throughout the county on Living Well with Chronic Conditions, Living Well with Diabetes, Fall Prevention and an Arthritis Foundation Exercise Program. For more information about these classes and workshops or to see a complete schedule please visit: slco.org/aging-adult-services/health-promotion-education/ or call 385-468-3200. In Clark County you can find more information in the Senior Services Directory at www.gethealthyclarkcounty.org/ pdf/senior-services-directory.pdf or by calling 702-455-4270.

learn

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INNOVATE

The Six-Point Mastery Classroom As Teacher

By Vanessa Maniago

Classroom as Teacher lives high up on the Six-Point Mastery Learning Model because it is a fundamental point of differentiation between Roseman’s and other universities’ learning environments, but also because it is the true physical “home” of mastery learning. The hexagonally-shaped classroom brings the student and professor much closer, driving engagement and content mastery. Dr. Tyler Rose, an Associate Professor of Pharmaceutical Sciences at Roseman’s South Jordan, Utah campus, knows every corner of the Six-Point Mastery Learning Model hexagon, its unique impact on how students learn and on how professors teach. In discussing what happens when a podium is removed and seats are compressed to no more than four or five rows, Dr. Rose equates the initial reaction to that of running into your teacher at the grocery store—at first it is a little bit jarring, but you quickly adapt and get comfortable. And after that moment, you feel you shared something. With class sizes anywhere from 80 to 150 students, Roseman’s classroom style makes the setting feel significantly smaller and more intimate. Students cannot retreat to the back of the room and lose interaction with the teacher—it just physically cannot happen in a classroom with only five rows in each seating section. A podium can also be both a physical and metaphorical barrier, a comfort to a professor and a shield to a student, and without it there are truly fewer barriers to effective learning. You might think this style would appeal to more open and social students, but how does it impact the students who are more shy or withdrawn? 12 | remEDy Summer 2016

Learning Model Story:

“Working in teams is another component of our work in the classroom setting, and how barriers to learning get broken down,” said Dr. Rose. “Students are assigned teams for the year, teams that comprise many different personality types and styles. We want students to learn to work in diverse settings, just as they will have to do when they get into their chosen field. This doesn’t just give them the distinct advantage of learning curricular content from one another, but also students learn to adapt and help those different from them. A high achiever might learn patience as she takes time to bring a teammate up to speed, and a less outgoing student may find his voice as he sees how his insights and contributions truly buoy the team.”

With interdisciplinary healthcare teams increasingly important in healthcare workplaces, this kind of training within the learning environment only prepares students more thoroughly. Dr. Rose has seen the impact of the hexagonal classroom on his students in class, but also appreciates how they talk about mastery learning after the fact as a graduate. “During exit interviews, where students have no incentive to be anything other than honest, I have always been impressed how overwhelmingly positive students feel about our model,” said Rose. “Though it makes for long, intense days, there is broad appreciation for the high degree of practical relevance engendered by mastery learning.” Beyond that, when asked if the

innovate

classroom as teacher prevents students who are pulling all-nighters or working while in school from falling asleep, Dr. Rose admits that “learning in the round” cannot work miracles. It does, however, allow him to be close enough to catch it early if it happens, and given the warm rapport he’s built with students, allows him to gently tease them back awake.

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Competency-Based Education Competency-Based Education, another critical point of the Six-Point Mastery Learning Model, is akin to the final stop, the ultimate challenge, or the “moment of truth” on the educational journey. Criterion-based reference tests use both qualitative and quantitative assessment to measure mastery after students have spent the previous days and weeks learning the material on which they will be assessed. As Deborah Hedderly, Assistant Professor in the MBA program at Roseman University says, “Either a student knows, understands, and can apply what he/she has learned, or cannot.” This very clear and definitive explanation underlies the idea of content mastery and course proficiency at Roseman. Students are not graded on a curve, and as such aren’t being affected by, or comparing themselves to, their peers. Many of them are still aware of how their classmates are doing, given the team-based nature of the program and the intimacy of the learning and assessment model. One would think that these standards might turn away some students, and that may be true. On the flip side, though, students who are uniquely suited for a greater challenge are drawn to Roseman and the task at hand; in Professor Hedderly’s case, leadership in the 21st century.

“Leaders have to be visionaries, leaders of change, team builders, content experts, humble, and demonstrate high emotional intelligence,” says Hedderly. Roseman’s academic programs, including the MBA program, are not for the faint of heart, which is why high-achieving students often seek out Roseman University. Research has shown that these students thrive on feedback, challenge and a chance to produce results based on their own efforts. With the Six-Point Mastery Learning Model, Roseman is able to offer what they need through continual feedback, assessments, team presentations and written work; and that is a lot more than most students get in traditional lecturebased learning models. Knowing you’ve received a 90% or above based on your own performance, not because of being graded on a curve, is yet another element that feeds the drive and ambition in these high achievers. With research indicating that hospitals and healthcare facilities need more MBA-educated staff members at every level, there is high demand for the best and brightest business healthcare leaders of the future. But what seems difficult and competitive also has a softer side. Professor Hedderly is aglow when talking about the breakthrough moments students have. “I love making a difference in the lives of the students. I look for them to have ‘aha’ moments, when all of their learning comes together…true leadership, however, is a lifelong journey.”

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Early Experiential Learning Early Experiential Learning in the Six-Point Mastery Learning Model places students into clinical and laboratory experiences early and often within every program Roseman offers. This experiential learning focus sometimes causes students some initial unease, but is the critical connection point between the didactic classroom portion of the learning and being out in the real world. “Putting students in the clinical setting early really helps them apply what they have learned. For many this is a time of putting the pieces together to make much more sense than the theory does alone,” said Delos Jones, Director of Clinical Resources at Roseman’s Henderson, Nev. campus. For many students this may represent the first interaction with patients in a clinical setting, such as a hospital, but their prior experience in the simulation lab and the hand-in-hand partnership with professors helps reassure them. “Having experienced, patient and knowledgeable clinical faculty helps the students become more comfortable in the clinical setting and grow their knowledge and skill levels,” said Jones.

This gets back to a key premise of the Six-Point Mastery Learning Model, which asserts that regular feedback allows the student to adjust and modify continually, then allows them to correct and evolve along the way. Instructors have the chance to work with students who may need a bit more help early on, building their foundation and preventing poor habits that they may later have to unlearn. With greater confidence, students move more quickly toward mastery and creating linkages that drive understanding and retention. Having multiple and varied inputs for information and experiences also supports different student learning modalities— encompassing kinesthetic, aural, visual and verbal styles. Roseman’s clinical experiences are both earlier and for longer periods of time than other programs, allowing students to see issues in the healthcare environment that they might not see were this time shorter. Issues with continuity of care, transition of care from unit to unit and how multidisciplinary teams interact are all front and center during experiential learning. These longer clinical “shifts” also prepare students for what is to come once they graduate. Roseman nursing students’ work follows the assessment and fundamentals coursework, allowing them to have a stronger basis from which to go into the clinical setting. Does this innovation in the curriculum truly produce a better practitioner? According to Jones, “Applying the knowledge and putting the students in the most realistic clinical situation possible helps prepare them for the real life of a working professional nurse.”

innovate

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EXPLORE

Special Report On Aging

This article originally appeared in the October 12, 2015 issue of The Enterprise newspaper (www.slenterprise.com)

Whatand is successful aging why is it important? By Tracy Hernandez

Here’s the bad news: getting older is an inevitable part of life. Contrary to popular belief, though, aging does not have to be a negative experience. Today a new idea is emerging that addresses the physical health as well as mental and emotional health of elderly adults to achieve what healthcare professionals are calling successful aging. So what does it look like to age successfully? In a society obsessed with youth, that phrase may sound like a sales pitch for something to make you look and feel 20 years younger, but Dr. Martin Lipsky, chancellor at Roseman University’s campus in South Jordan, who was previously a family physician, defines successful aging using three criteria: 1. Avoiding disease and disability 2. Maintaining high physical and mental function 3. Engaging in social or productive activities Successful aging goes beyond “active aging” to include more than just exercise. It’s a broad range of things that can contribute to happiness and reduce disease. 16 | remEDy Summer 2016

“What healthy aging really looks like is keeping meaning in someone’s life,” said Dr. Lisa Rosenberg, the Director of Geriatrics and an assistant professor at Roseman’s College of Medicine, a program currently in development at the university’s Summerlin, Nev. campus. “When people retire they often focus on what they are not going to do: they are not going to get up early, they are not going to the office, they are not going to work; but they end up feeling kind of empty.” “People feel like they need to have meaning to their life. Now that’s self-defined and will be different for everyone,” said Lipsky. For someone who finds fulfillment as a professional, things like teaching, doing volunteer work, or mentoring students in retirement can help them stay engaged and excited to get up every morning.

Others decide that, while they enjoyed a successful career as a professional in one field, they have always wanted to try something else and in retirement they launch a sort of “second career,” perhaps going back to school, taking classes at a community college, finding a new hobby, or spending more time with family and friends. “We know that it’s really healthy for the aging brain to learn new skills, and we think it’s a buffer against dementia and cognitive losses to actually learn new skills,” said Rosenberg. “Choose activities that will make the brain create new cognitive pathways.” Go to a local music school and learn to play the piano, for example, or find out if your local library has language classes you can take for free. Senior centers are another place where you can go to find classes and support. “Humans are very social. We need interaction, and we need to feel like we make a difference,” said Lipsky. “Many people who feel like they are aging successfully say it’s because they are making a contribution to society, which lessens the feeling that they are a burden to others.” Having that ‘meaning’ can also be a buffer against things like depression and isolation, or prevent people from engaging in harmful behaviors such as gambling, drinking, spending money inappropriately, or drug abuse, says Rosenberg. This focus on creating meaning in retirement does not take away from the need for a healthy lifestyle, though. There are five key behaviors that most people know they should engage in, says Lipsky, including: • Avoiding or quitting smoking • Getting 150 minutes of moderate exercise each week (about 30 minutes a day, five days a week) • Drinking alcohol only in moderation or not at all • Maintaining a normal body weight • Eating five servings of fruits and vegetables and 25 grams of fiber each day

Other things to add to the list for optimal physical health include seeing a doctor for regular checkups and screenings, and visiting your dentist at least once a year. In recent years researchers have discovered links between chronic illnesses like diabetes and coronary heart disease and dental health. When you see a dentist regularly, he or she can spot subtle changes in your gums, teeth, and bones that could be indicators of more serious health conditions. Regular cleanings also help keep inflammation and infections under control to prevent tooth loss or decay. For someone 65 or older, Rosenberg also recommends that your checkups include screenings for common issues that older adults face, such as cognitive screenings for dementia or memory issues, depression screening, screening for falls or risk of falls, and vision screening by an eye doctor or an optometrist. Perhaps one of the most important things to do during your annual checkups is to communicate with your doctor and ask questions. “Don’t attribute something to aging without talking to a healthcare professional first,” said Lipsky. “There is a lot of information suggesting that older individuals underreport diseases and other problems because they think these things are inevitable and a normal part of aging.” “Older adults often attribute things like dizziness, falling, incontinence, or bowel issues to aging when they could actually be fixed by a primary care physician, and in some cases without the need for medication or surgical interventions,” said Rosenberg. “It’s really important to not hide these things from your physician.” Dizziness and falling are especially dangerous for older adults, says Clapp. Someone who is not actively engaged in physical activity during their younger years often loses a significant amount of muscle mass as they age. When large muscle groups like those around the hips and legs deteriorate, a person is at a significantly higher risk of falling and getting injured, which can be debilitating and even deadly for an older adult. “Only about 13 percent of elderly adults who fall are able to return entirely to their pre-fall capabilities,” said Clapp, leaving almost 90 percent who have some type of limitation following a fall. Falling once is also a significant risk factor for future falls, so even if you escape injury the first time, you may not be so lucky in the future.

Keep in mind that ‘moderate exercise’ does not necessarily mean joining a gym—it could be as simple as walking, gardening, or housework. Dr. Kara Clapp, an assistant professor in Roseman University’s College of Nursing, also advocates strength training as part of your exercise routine to counteract the loss of muscle mass that happens as you age. “Almost everybody over the age of 40 needs to do some form of weight training. We’re not talking about turning everybody into a musclehead, we’re just talking about some basic strength exercises in addition to cardio,” she said. It’s important to discuss the exercise regimen with your doctor so they can help you figure out safe exercises based on your ability level, or refer you to a physical or occupational therapist. Dietary changes that add more lean protein to your diet may also be helpful to prevent or slow muscle loss, says Clapp. If you’re concerned about muscle loss, talk to an exercise physiologist or someone who specializes in sports nutrition to help you figure out exactly how much protein you need for your current activity levels and how to get that in your diet in a way that is safe and effective.

Beyond telling your doctor about these symptoms and issues, talk to your pharmacist as well. “Many drugs can have interactions that can lead to things like dizziness, falls, or vision problems,” said Rosenberg, and your pharmacist can help you understand which side effects might be related to your medications. They can also spot potentially dangerous drug interactions if you take multiple medications, or make recommendations for alternatives that might have fewer side effects. “The most important thing to remember is that it’s never too late,” said Lipsky. Things are going to change as you get older, and certain diseases and risks increase with age, but that doesn’t mean you have to resign yourself to being unwell as you get older. Getting the right care and paying attention to your physical, mental, and emotional well-being can help you age successfully.

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THE IMPORTANCE of PALLIATIVE CARE in CHRONIC DISEASE or LIFE-LIMITING DIAGNOSIS By Brian Sodoma

When a medical professional speaks to the importance of palliative medicine, it’s very easy for the conversation to swing towards what palliative care is not. And for good reason. For years, palliative care has been synonymous with hospice; but hospice is an insurance offering for end-of-life care, while palliative medicine can be applied in many situations beyond the hospice environment.

Rosenberg shared some insights on what effective palliative care entails and how using it can help so many people battling chronic health conditions or life-limiting situations to enjoy day-to-day activities in ways previously unimagined.

“It’s important to note that palliative medicine is not always synonymous with the end of life,” said Lisa Rosenberg, MD, Director of Geriatrics at Roseman University of Health Sciences.

Palliative care focuses on pain management, often when curative approaches are abandoned, and stress reduction, symptom management and quality of life become a higher priority.

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Quality of Life Takes the Lead Palliative medicine is a multi-disciplinary subset of medicine that can even apply in pediatric cases, where some children may battle cancer or other lifelong chronic illnesses. In 2006, palliative medicine became an approved sub-specialty for U.S. medical students who completed training in internal medicine.

“For some, pain management can be more burdensome than physical health issues,” Rosenberg added. “Palliative care focuses more on what meets the patient’s interests and needs over prolonging life and sticking to guidelines.” A cancer patient, for example, may forego chemotherapy, but instead opt for radiation and other therapies less taxing on the body that may allow him or her to better enjoy everyday life. This approach can help the patient enjoy family events and daily activity, even though aggressively treating for a cure is not part of the plan. It doesn’t necessarily mean the person has given up—some cancer patients who opt for only palliative care may live for years, Rosenberg noted.

to prolong life, Rosenberg noted, at the expense of the quality of life. It may take several family members or other friends and loved ones to convince this person to shift his or her perspective.

where a physician presented findings about better pain management results with seizure medications; he tried the approach and was pleased by what he saw.

Healing family relationships is also critical. There may be estranged children and other family tensions that have lived on for years, but with the guidance of a behavioral health professional, those problems could be resolved. That can play a huge factor in managing a patient’s pain and can also help the group more easily navigate decisions about the patient’s care.

“I learned that opioid medications did nothing for musculoskeletal pain, but the seizure medicines quieted down irritable nerves (as in neuropathy) quite well,” Karagiozis added.

Manipulating Pain Michael Karagiozis, DO, is the medical director for the Southern Nevada branch of the AIDS Healthcare Foundation. For Karagiozis, palliative care came into play in the 1990s when he was treating AIDS patients with early drugs that came with harsh side effects and neurotoxicity. The experience taught him a lot about how the body and mind experience pain.

“The reason manipulation can work is because you’re sending a signal to the brain telling it nothing’s wrong,” he said.

For those patients facing end-of-life decisions, the goal may be to avoid being bedridden. Rosenberg recalls a kidney failure patient who did not want dialysis, but instead wanted enough medical intervention to allow her to enjoy two upcoming family events. Blood transfusions and pain medicines were used to help the patient enjoy those engagements before she “The reason manipulation can work is passed away, Rosenberg said.

because you’re sending a signal to the

Getting the Timing and brain telling it nothing’s wrong,” Conversation Right Rosenberg says the palliative care conversation often comes too late, when curative approaches have “The single most important thing I been exhausted, perhaps a strong physi- can tell you is that pain is experiential. cal toll has been taken on the body, and It’s experienced in the brain,” he said. when there may be less of a feeling And it can be difficult to understand of hope. the actual cause of pain, particularly in cancer patients and diabetics with “At diagnosis, there are so many things neuropathy, he added. to talk about, and typically palliative care is brought up very late in the “Cancer is one of the most bizarre disease process…Palliative approaches situations,” Karagiozis said. “You’re should really be used at the time a not experiencing the pain from the chronic disease is diagnosed. You nail in the foot. It’s a fake nail… don’t need the conclusion that it is That’s why palliative medicine is not curable,” she said. important to hospice. Two-thirds of hospice patients have cancer and Creating a positive palliative care bizarre pain syndromes far out of experience involves several elements, proportion to any physical explanation.” but first and foremost you need to be able to get family members on the Treating pain for those with chronic same page, and that can sometimes conditions can be tricky. In his early be difficult to accomplish. years of working with AIDS patients Karagiozis treated it with opioid Oftentimes there may be a family medicines like morphine without good member who is pressuring the group results. In 1997 he attended a conference

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Manipulation has also been found to be helpful for fibromyalgia sufferers and other pain management situations, he added.

A Low-Tech Approach Rosenberg also emphasizes the importance of physically touching in palliative care. Often when a person is in hospice or a nursing home, they are only touched when it’s time to change clothes or take care of basic grooming needs, but holding a hand or stroking a forehead can work wonders for a patient. “This is a big piece, a shift from high- to low-tech. It’s not about catheters and dialysis, but making sure someone is sitting beside the bed,” she added. Companionship and human touch can also help caregivers avoid tense situations with dementia patients. “Sometimes keeping them company, it doesn’t look like much, but a soothing voice and focusing on things like calming music can help them feel less threatened,” Rosenberg said. As the importance of palliative care grows, Roseman University’s medical program (which is in development at the Summerlin, Nev. campus) will facilitate a geriatric medicine fellowship in the future that will place an emphasis on this sub-specialty of medicine, according to Rosenberg. With more and more patients being diagnosed and living with chronic illness, it’s an essential part of caring for both the emotional and the physical needs of patients. remEDy Summer 2016 | 19

USING SHIP SERVICES & ROSEMAN

to Help Navigate Your Way Through Roseman University College of Pharmacy is passionate about helping our community. Through a partnership with the Nevada State Health Insurance Assistance Program (SHIP) pharmacy doctorate students are volunteering their time to be trained and provide Medicare counseling services. During the summer of 2015, Roseman opened its first on-campus Medicare Call Lab dedicated to help patients outside SHIP’s regular business hours navigate the complex world of Medicare and find cost-effective Medicare plans. Medicare Part A:

Medicare Part B:

Medicare Part A covers hospital insurance (if it helps you can think “admitted” for Part A). Services that may be covered include inpatient hospital stay, skilled nursing facility, home health, hospice, and blood bank services. Keep in mind that even if an item is covered, the patient may still have co-pays or deductibles to meet. Part A has no premium if you are eligible for this coverage through qualifying FICA tax contributions, and patients can verify eligibility with the Social Security Office. Beneficiaries who do not qualify for premium-free Part A may pay up to $411 per month for Part A coverage in 2016. If you do not buy Part A when first eligible you will receive a penalty of a 10 percent additional cost for every 12 months without coverage. This late enrollment penalty does not apply if you have Creditable Coverage from your own or a spouse’s employer, but once the Creditable Coverage ends, you have 63 days to enroll in Part A. Understanding the difference between inpatient and outpatient care is key to understanding how you are billed for your time in a hospital. Being inpatient requires a formal admission order from a doctor. Spending an overnight stay in the hospital does not necessarily qualify you as inpatient unless this formal admission order is documented. If you are not sure if an admission order has been written, ask your provider for clarification.

Benefits covered under Part B include doctor’s visits, home health, outpatient hospital services, clinical lab tests, durable medical equipment, preventive screenings, and mail order diabetic supplies. It comes with an monthly premium of $121.80, and an annual deductible of $166 in 2016, with 80/20 coinsurance after the deductible. Some individuals may pay a higher premium based on their tax bracket (visit www.medicare.gov for more information). It’s important to note that Part B does not cover routine dental, vision, and hearing exams. If a beneficiary does not enroll when first eligible there is a lifetime penalty added to the premium based on the amount of time the beneficiary was without coverage.

HOSPITAL INSURANCE

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OUTPATIENT INSURANCE

A key point to note is that Part B covers more than 25 preventive services to help you stay healthy, including annual “wellness” visits, bone density measurements, mammograms, glaucoma tests, immunizations, screenings for colorectal cancer, cardiovascular health, diabetes, prostate cancer, and many more. Part B may also cover certain durable medical equipment, but keep in mind that you may need to purchase it from a supplier that contracts with Medicare.

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Medicare

By Dr. Catherine Oswald and Agafe Saguros, Second-year Pharmacy Student

SHIP is a statewide volunteer-based Medicare counseling program administered by the State of Nevada Aging and Disability Services program. Medicare information comes directly from Centers for Medicare and Medicaid and Administration for Community Living. SHIP-certified students take calls Monday through Thursday between 4 and 7 pm, and Saturday from 10 am to 2 pm. In February Roseman also started a neighborhood educational series at its Summerlin, Nev. campus, beginning with the topic “The ABCD’s of Medicare”. If you missed the presentation, here is a general overview of Medicare’s four main parts. Medicare Part C:

MEDICARE ADVANTAGE PLAN

This is a health plan offered by a private company that contracts with Medicare to provide Parts A, B, and D benefits, and in order to qualify you must be enrolled into both Parts A and B. Advantage plans generally fall into Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), or Special Needs Plans (SNP). With an HMO plan you must receive services from healthcare providers in the plan’s network, and most require you to choose a primary doctor and get referrals from this doctor to see a specialist. PPO plans, on the other hand, allow you to go out of the plan’s network and do not require a referral to see a specialist. They may provide vision, dental, and hearing services, but usually at an extra cost. ASNP provides healthcare for specific groups of people, such as those who live in a nursing home or have certain chronic medical conditions.

Medicare Part D:

PRESCRIPTION DRUG

Like Part B, Part D premiums can vary depending on income, and there is a lifetime penalty applied to the premium if you do not enroll once eligible. Something unique to Part D is the coverage gap, often called the “donut hole”. Part D covers medication expenses up to $3,310, but until you reach the “catastrophic coverage” threshold of $4,850 in true out-ofpocket costs (yearly deductible, coinsurance, and copayments on covered medications) you are in the “donut hole” paying 45 percent toward brand-name and 58 percent toward generic drug costs. Once you reach catastrophic coverage you are only responsible for the coinsurance or copayment for covered drugs through the remainder of the year. This gap of over $1,500 is often a financial hardship for seniors on a fixed income who need medication before they reach catastrophic coverage.

Each component of Medicare is unique and has a specific set of costs and covers a specific set of services. There are also extra help programs to help cover costs if you meet income eligibility. If this all seems pretty confusing or you have any questions, contact the Roseman University Medicare Call Lab for Nevada residents only at 702-968-6615 today.

N E I G H B OR HO OD H E A LT H S E R I E S Upcoming Neighborhood Health Series Events Thursday, September 15 5:30 - 7 p.m.

“Demystifying Cancer, A Disease That Has Affected Us All” Dr. Sanford Barsky

Thursday, October 13 5:30 - 7 p.m.

“Help with Open Enrollment: The ABC’s of Medicare” Dr. Catherine Oswald

Giving To Those Who Risk Everything Some of the most amazing things that come out of any conflict are the heart-warming stories about the people who labor to save lives, better living conditions, and promote and preserve the American way of life. Our veterans, women and men who have put themselves in harm’s way, have chosen a very time-limited career to help our country. When they leave the services and return to civilian life, they rarely have a job waiting for them. Roseman University, thanks to a three-year grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), is making it possible for some of these selfless individuals to gain new skills and a new career path in a program called the Veteran to Bachelor of Science in Nursing degree. Through this program, veterans who earned a military healthcare specialist rating in the past five years of their service can obtain a sought-after degree in a respected field that is always in demand. Naturally, the Veteran’s Administration and other federal agencies help today’s vets with job placement and job training, but not every cost is covered. Your gift to support a student enrolling in this program could have a huge impact on their lives and eventual graduation. To learn more, contact Brenda Griego at (702) 802-2830 or BGriego@Roseman.edu. Show your pride with support!

By Dr. Douglas Ashman, Prosthodontist

Let’s face it: as a nation we are going gray. The Baby Boomer generation is now heading into their 60s and 70s, and the percentage of Americans in this age group is expanding like never before. Along with what some may consider a more distinguished appearance, that gray hair also can come with health issues that are increasingly more expensive. According to a 2013 report by the Centers for Disease Control and Prevention (CDC) titled The State of Aging and Health in America, “The growth in the number and proportion of older adults is unprecedented in the history of the United States. Two factors—longer life spans and aging baby boomers— will combine to double the population of Americans aged 65 or older during the next 25 years, to about 72 million. By 2030, older adults will account for roughly 20 percent of the U.S. population.”

The Kaiser Family Foundation, in the 2015 Medicare spending and financing fact sheet, projects that Medicare spending will nearly double over this decade, from $555 billion in 2011 to $903 billion in 2020, which is good for your general health, but actually doesn’t do much for your dental health because Medicare does not cover dental procedures except in very extreme circumstances. To get the basics like cleanings, fillings, extractions, and dentures, you need to purchase a separate dental coverage plan. As a person ages, there are a lot of changes in your mouth, and many of these things can result in tooth loss, which means that you will need to get dentures or other restorative dental work to replace those teeth. Some of these changes are naturally occurring while others come about by lifestyle choices or are side effects of the medication you take. For example, most people see a decrease in their skin’s elasticity, which causes your face to droop or sag. This doesn’t necessarily affect your physical health, but it can cause you to feel less secure about your outward appearance, leading to neglect of oral health processes like brushing and flossing twice a day, or getting professional cleanings at your dentist’s office. Poor oral hygiene is a common cause of tooth loss from dental cavities and gum disease. Decreased salivary flow is also common in older patients. Often it is a side effect of necessary prescription medications, but a patient on multiple medications may have less than half the normal salivary flow. Without enough saliva, you are at much higher risk of developing cavities that can lead to tooth loss. Periodontal disease—commonly known as gum disease— is more likely in older patients, especially those with other chronic health conditions such as Type 2 diabetes. The inflammation from periodontal disease can cause infection and decay, and in advanced stages can destroy the primary support mechanism for your teeth—the gums—causing tooth loss.

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Besides being a quality of life issue, a person with missing teeth often suffers from nutritional deficits as well. According to several studies, tooth loss can affect general health in several ways: • Eating fewer fruits and vegetables, less fiber and carotene, and more cholesterol and saturated fats

Sometimes as a result of a stroke, arthritis or dementia, manual dexterity declines to the point that a person is unable to do things such as brush and floss without the help of a caregiver. If needed, it's important to get that help because the absence of thorough, regular care, of dental cavities and gums, can lead to tooth loss.

• Higher prevalence of obesity, and an increased risk of cardiovascular diseases and gastrointestinal disorders • Increased rates of chronic inflammation in the stomach, leading to higher risk of upper gastrointestinal and pancreatic cancer, and higher rates of ulcers

Regardless of how it happens, tooth loss has a serious impact on the health and well-being of everyone. Stop and think for a minute about all the benefits that your teeth provide—specifically the ability to eat the meals that you love. When a person is missing one or more teeth, eating becomes more difficult (or even impossible if you have few or no teeth), and not being able to eat a variety of foods means you probably are not getting the nutrients you need for optimal health.

• Increased risk of developing diabetes • Increased risk of heart abnormalities, hypertension, heart failure, stroke, and other coronary diseases

While the U.S. population as a whole has a lower rate of edentulism (the term for someone who is missing one or more teeth) when compared with other Western countries, this condition still affects 15 percent of people age 65 to 74, and close to one in four people age 75 and older. An article published in the International Journal of Dentistry in 2013 highlights the problem. “There is overwhelming evidence showing the negative effect of edentulism on oral-health-related quality of life. Edentulism negatively influences not only oral function, but also social life and day-to-day activities. Compromised oral function has been linked to decreases in self-esteem and a decline in psychosocial well-being.” Many people with missing teeth are embarrassed to eat, smile, or speak when others are around, and will instead avoid social situations altogether, leading to isolation. Even with dentures people often have limitations, and worry that the dentures will not stay in place when speaking and eating, which leads to a decrease in self-confidence and changes in behavior to avoid being around others in social situations.

• Difficulty with daily physical activity and other things that contribute to quality of life • Increased risk of chronic kidney disease • Potential risk of sleep-disordered breathing, including obstructive sleep apnea If there are people in your life over the age of 65, encourage them to be mindful of their oral hygiene and seek regular professional care to maintain their teeth for their entire lives. A person with missing teeth should be guided to replace them with either removable dentures, fixed bridges or implants, and it’s important to know that many advances in recent years make replacing missing teeth much more comfortable, affordable and predictable. A full set of teeth, whether natural structures or artificial replacements, do a lot to enhance your physical, psychological and social well-being. Indeed, few pleasures in life can compare to the enjoyment that comes from being able to eat a delicious meal or being able to flash your pearly whites when you smile and laugh.

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DISCOVER

Reinvention:

Making a Change in Your Mid- to Late Career By Dr. Deb Hedderly

The days of working for the same company throughout your career are gone, and for many job seekers who reach their mid- to late career, this can make the prospect of getting hired a little more difficult. Data suggests that people who are in their 40s and 50s are likely approaching the peak of their professional career, where experience and expertise are aligned with enthusiasm and ability to work, but what happens when you’re at that peak—or just a few years down the road—and you want or need to change jobs?

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Network, Network, Network! Almost 30 percent of employees in larger organizations are hired by referral, so now is a great time to pick up the phone and ask a friend or acquaintance for a referral or advice on how to get hired at the company where you want to work. Join professional organizations to meet new contacts, use social networks (online and offline) to find people you worked with in the past, and be sure to ask for an introduction if they know someone who needs an employee with your skill set.

Millions of people today will continue working well into their 60s and 70s, either out of necessity or simply because they’re not interested in retiring at the “traditional” ages of 60 to 65 years. Whether you experience a life change that requires you to find a new job in your mid- to late career, or you are just ready for a new challenge, it’s important to understand how to stand out in the job search and be able to overcome some of the challenges that someone earlier in their career might not even be thinking about: dealing with changes in your own personal health, taking care of children or grandchildren, caring for an elderly family member, or deciding to pursue opportunities in a new industry with limited experience or education.

Prepare for the Interview Regardless of where you are in your career, if you’re planning to go for an interview you want to make sure you are dressed appropriately. You might also want to do a little research in advance so you know what others at the company often wear to work. For example, if you’re interviewing at a tech company or startup where everyone brings backpacks and wears jeans and t-shirts you might seem out of place in a formal suit, and a business casual (but still professional) outfit would make you seem like a better fit.

The landscape for finding and applying for jobs has changed with the explosion of social media and technology over the last decade, but the good news is that you can combine your extensive experience and expertise with a few updated job-search strategies, and be on the road to getting hired for that ideal position. Create a LinkedIn Profile Kerry Harmon in her 2013 article The 11 Biggest Mistakes Older Job Hunters Make reported, “A recent study by the Society for Human Resource Management found that 77 percent of employers are using social networks to recruit…[and] among the recruiters using social tools, 94 percent said they used LinkedIn.” Begin your job search by creating a profile on the networking site. Post a professional photo—try to avoid snapshots, pictures with others in them, or low-resolution photos—and reach out to connect with your own colleagues from past employers, anyone who is currently working at a company that you have targeted for employment, or anyone currently working at a similar company or profession. They may be able to help you get an introduction to hiring managers, or make recommendations when they hear about jobs that fit your skills.

Expand Your Education Learning new things, even just as a hobby, can provide you with new skills and capabilities that are useful in a job search. If you are not tech-savvy, for example, take classes or practice on your own time to develop that skill. If you are thinking about changing to a completely different career, find classes at a local college or university, or enroll in adult education classes available in the evening to learn skills that would be useful in your new career. Don’t Wait for the Phone to Ring While you are job hunting, volunteer or do some pro-bono work. According to LinkedIn research, 42 percent of hiring managers consider volunteer work as important as actual work experience. The bonus is that you can give back while you are gaining valuable experience, and sometimes following a passion via volunteering can lead to a position within an organization or with a cause that you love.

Update Your Resume Recruiters will spend only 20-30 seconds scanning your resume, so you need to quickly catch their attention. Make sure your resume is no longer than two pages. Depending on the number of jobs you have held, you may want to limit it to the last 10 to 15 years or only highlight the skills that you have that will meet the job requirements for your ideal position. Since titles do not indicate what you did, include bullet points of your accomplishments. If you are returning to the job market after a hiatus, include recent skills you may have used when volunteering or doing pro-bono work.

Use Your Age to Your Advantage The median tenure with a current employer is 1.3 years for individuals 20-24 years old, and only 3.2 years for individuals 25-34 years old, according to a 2012 report. Employers, meanwhile, are concerned with employee retention because of the high cost of turnover and hiring and training new employees. You can use this to your advantage by highlighting what older generations are known for—stability, loyalty, and experience in the workplace. Reinvention in your mid- to late career is possible, and can be exciting if you are up to the adventure.

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By Cathryn Barber, MSN, RN

Each year millions of older adults over the age of 65 experience falls. This is a very serious health problem, and one that can significantly affect your health and healthcare costs. Once you fall the likelihood of falling again doubles, but despite that fact, one in three people who fall every year never report it to family or to their doctor. Falls in older adults are one of the major causes of mortality and morbidity, as well as a major cause of immobility and premature nursing home placement.

Falls are a very serious concern. According to the Centers for Disease Control and Prevention (CDC): • One out of five falls causes a serious injury such as a broken bone or a head injury • Each year, 2.5 million older people are treated in the emergency room for fall-related injuries • Over 700,000 patients a year are hospitalized because of a fall injury, mostly because of a head injury or hip fracture • Each year at least 250,000 older people are hospitalized for hip fractures • More than 95 percent of hip fractures are caused by falling, usually by falling sideways • Falls are the most common cause of traumatic brain injuries (TBI) • The direct medical costs for fall injuries are estimated at $34 billion annually Let’s take a minute and define “falls”: A fall can be any sudden, unintentional change in position causing an individual to land on an object or the ground. Most falls happen within a person’s home or somewhere near their home.

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It’s helpful to think about your own risks related to your personal health and habits and discuss any specific concerns with your doctor or another healthcare provider. Here are a few questions you can ask to get you thinking about those risks: • Do you have medications from the doctor that make you weak or lightheaded? • Do you have muscle weakness or sometimes feel unstable when you walk? • Have you had prior troubles with balance? • Do you have visual problems and need glasses? • Do you have diabetic neuropathy (pain or numbness in your feet)? You can also check around your house, or have a friend or family check to see if you have anything that might put you at risk for falls, such as: • Uneven floors in your house or changes in the flooring from room to room • Icy steps or walkways outside the house • Water on floors • Tears in or uneven rugs or carpeting • Debris or papers left on floors • Animals or small children that can be under your feet • Stairways that are not lit or have no handrail • Bathrooms without assistive devices to help get in and out of the tub

The good thing about falls is that in many cases they are preventable. As an older adult you should be incorporating strength and balance training into your daily routine because building up your legs and core will help improve balance. It’s also important to know your medications and understand which ones make you feel dizzy, tired, or weak, and always discuss these symptoms with your doctor or pharmacist just in case this is not a common side effect and should be addressed. For those with other chronic health conditions, talk to your doctor regularly about what side effects and symptoms you should expect from medications or from these health conditions. Be sure to schedule annual physicals and yearly eye appointments, and get lab work done so your doctor can find out if you are low on some essential nutrients or vitamins that could be addressed with daily supplements or medication. That might include iron, vitamin D, calcium, or others. Finally, after you (or a friend or family member) assess your personal surroundings for safety, make arrangements to have someone keep your

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home safe. That might include hiring a handyman or having a family member add some extra lighting to stairwells or outside your home to allow you to see better, having someone come over to shovel snow and remove ice from your walkways, and getting a volunteer to come and pick up your house to remove any debris or items from the floors that could be a hazard. When you’re alone, avoid climbing on chairs, stools, or ladders, and find someone who can help with other potentially dangerous tasks around the house like removing Christmas lights, cleaning your gutters, and sweeping and mopping the floors. Falls can have serious consequences for you and your family. Rather than trying to recover after you take a serious fall, take a few steps to prevent it from happening in the first place if possible. remEDy Summer 2016 | 27

Making a

DIFFERENCE One Brown Bag Medication Check-up at a Time By Kristie Holbrook & Debbie Beckstrom, PharmD students & Rachael Wadley

Are you or a loved one taking multiple medications? Roseman University provides a free service to the community called a “Brown Bag Medication Check-up” to review those items and make sure there are no issues. This type of event is quite literally what it sounds like—patients bring medications they are currently taking in a brown paper lunch sack and sit down with pharmacists for a free medication consultation—and Roseman’s pharmacy students are happy to offer it as a service. “We ask participants to bring all the medications they are currently taking,” said Donna Eom, a Doctor of Pharmacy (PharmD) candidate from the Class of 2017. “Student pharmacists then review all of their prescription medications as well as over-the-counter and herbal supplements to determine if there are any interactions and ways to optimize treatment.” Medications discussed can range from diabetes and heart disease prescription drugs to vitamins, herbal products and anything in between. This one-on-one time with a pharmacist provides opportunities for patients to learn more about how the drugs work, why they 28 | remEDy Summer 2016

are taking them, and any special recommendations about how to take specific drugs. For example, did you know that the commonly prescribed thyroid medication levothyroxine works best if it is taken by itself, 30 minutes before any other drugs or food? Statin drugs, a medication class used for treating high cholesterol. work best if taken at night because that is when the body processes fats and triglyceride levels rise. Depending on the event, Roseman students, with the assistance of pharmacy faculty, combine this medication review with blood pressure, blood sugar and blood cholesterol screenings to determine if the patient is properly adhering to their medication regimens, or if they may need to check with their doctor for adjustments to medication therapies. “These brown bag medication check-ups are important because pharmacists are the most accessible healthcare professionals and as student pharmacists, we aim to be an extension of that by connecting with our community through health fairs and events,” said Eom.

While anyone can consult a pharmacist at any time about medication information and interactions, pharmacists in retail settings typically do not have 15 to 30 minutes to completely review the patient’s medications. At the Brown Bag Medication Check-up events Roseman pharmacy students and faculty have no time limit. They are able to spend as much time as needed to completely review the patient’s medications as well as counsel them on the proper way to take them. Another important benefit of attending a brown bag event is that pharmacists can discuss medication-related side effects with patients. These can range from simple things like coughing or dry eyes to more serious things like muscle pain and weakness. During a recent brown bag event hosted by Roseman University’s NCPA chapter in South Jordan, student pharmacists spoke with a patient who had been taking a statin drug. The medication wasn’t achieving the benefits wanted so the patient’s doctor prescribed him a different (and more potent) statin medication, but the patient misunderstood his doctor’s instructions

and kept taking the original statin drug plus the newly prescribed drug. He developed rhabdomyolysis, a condition where muscle tissue breaks down causing severe muscle pain and weakness, and one that can have serious, even fatal, consequences. Clarifying that the patient only needed to be taking the most recently prescribed statin may have saved his life. In addition to talking about prescription drugs, pharmacists can use the time during a medication consultation to discuss vitamin and herbal supplement use. Many patients don’t take into consideration that supplements may interact with their prescription drugs. These interactions can lead to serious adverse effects. Roseman’s Student Alliance organization in Henderson has also provided Brown Bag Medication Check-up events at a variety of senior centers. “We quickly realized that seniors are often unaware of why they are taking their medications, only that their doctor told them to. They may be taking duplicate medications prescribed from different doctors, and it is not until a student pharmacist reviews it with them at a Brown Bag Medication Check-up event that they realize it,” said Eom. “As future pharmacists, we have been trained to ask the right questions that may have been missed at the doctor’s office or weren’t asked at their local pharmacy.” Individuals interested in participating in this service can attend one of the various events that Roseman hosts or participates in that are open to the public. Roseman has held and participated in health fairs and annual events

with many partner organizations in Southern Nevada and the Salt Lake valley. Students also visit centers like the Las Vegas Rescue Mission, senior centers, public schools and cultural/religious centers. The events are typically advertised on public radio, in newspapers, social media and in mail circulations, and we collaborate with various organizations in the community to arrange and conduct these events. Over the last 12 months Roseman has assisted 103 patients with Brown Bag Medication Check-up reviews, checking a total of 856 medications which included prescription, over-the-counter, herbals, and supplements. “In the Las Vegas area, we had six dedicated brown bag reviews, one at Roseman University Henderson campus, three with HealthInsight and two with Tzu-Chi Buddhist Foundation, plus we also do medication reviews at all our health fairs,” said Dr. Mark Decerbo, associate professor of pharmacy practice and Student Alliance faculty advisor. A brown bag event is a great opportunity to speak one-on-one with a pharmacist to discuss any medication questions. Pharmacists are the most accessible healthcare professionals and are always ready and willing to help with any concerns that patients have. So while you may not get a free lunch at a brown bag event, you will get valuable medication knowledge and that will be free of charge! If you are interested in attending or hosting one of Roseman’s Brown Bag Medication Check-up events or health fairs in Nevada or Utah, please email marketing@roseman.edu.

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ROSEMAN UNIVERSITY

EXPANDS COLLEGE OF NURSING OFFERINGS By Jason Roth

With more Americans gaining health insurance and seeking healthcare services, the demand for registered nurses remains strong across the country. Along with the overall demand for registered nurses there is an increasing call by professional organizations and hospitals for nurses with a bachelor’s degree. The Institutes of Medicine (IOM) published a report in 2010 that highlighted the importance of nurses with a baccalaureate education. Today, about one in three nurses have a Bachelor of Sciences in Nursing (BSN) degree, but the IOM recommended increasing that number to 80 percent of all nurses who are working in clinical settings by 2020. The report found that nurses with a bachelor’s degree enjoy more employment and career advancement opportunities and higher pay than their associate degree trained peers. The average salary nationwide for a registered nurse is $67,220, while the average salary of nurses with a BSN is $74,000. Many employers today prefer nurses that have a BSN to those with an associate’s 30 | remEDy Summer 2016

degree. As hospitals work to achieve “Magnet” designation from the American Nursing Association, which requires 100 percent of nurse managers at their hospital to hold a BSN, it is prompting facilities to focus their hiring on BSN graduates versus those with an associate’s degree and RN license. The Veterans Administration, for example, now requires all of its nurses to have a bachelor’s degree. “This is a significant transition in the profession of nursing,” said Dr. Brian Oxhorn, dean of Roseman University’s College of Nursing. “It is in response to the demands of an evolving healthcare system, and ultimately it will help the profession meet the changing needs of patients.”

Roseman University’s College of Nursing is helping existing registered nurses who currently don’t have a BSN to earn one while minimizing the disruption to their current work responsibilities. In January, the College of Nursing expanded its offering of nursing degree programs with the creation of a nine-month (35-week) RN to BSN program. “Roseman University’s new RN to BSN program is structured to support working nurses in completing their baccalaureate nursing education while continuing their day-to-day responsibilities,” said Oxhorn. “This offers nurses the opportunity to expand their clinical and theoretical skills and knowledge so they are better positioned to advance in the profession.”

Roseman University’s College of Nursing utilizes the university’s Six-Point Mastery Learning Model, which includes a block curriculum where students take only one class at a time, focus intently on that content area, and master the content before proceeding to the next block or course. The RN to BSN program consists of eight blocks, each taught online by expert faculty with a myriad of clinical, educational and professional backgrounds. The program also includes two one-week, on-campus residencies at the university’s Henderson, Nev. campus. Students are assigned to groups for specified learning activities to develop leadership, communication and team skills, and complete projects that enhance their previous clinical experiences.

nursing careers. Roseman University is the only institution to be awarded the grant in the Intermountain West region.

Another area of focus for Roseman’s College of Nursing is helping veterans achieve civilian career success. In October 2015, the College of Nursing at its Henderson campus was awarded a three-year, $1.05 million grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), to support military veterans’ transition into high-demand, professional

Working closely with the Department of Veteran’s Affairs, Roseman University’s nursing program provides veterans the opportunity to receive academic credit for prior military training, experience and leadership. The program also addresses the physical, emotional and environmental issues that may be unique to veterans that could potentially impact learning, completion of the program, and the ability to

The HRSA projects that grants awarded to Roseman’s College of Nursing and 30 other institutions across the country will enable more than 1,000 veterans nationally to obtain BSN degrees. Under the grant, Roseman University and other recipients recruit veterans and prepare them as undergraduates for practice and employment in local communities. The grant also develops career ladders that include academic and social supports, career counseling, mentors, and links with veteran service organizations and community health systems.

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gain employment once they graduate. This includes faculty development activities to enhance faculty understanding of military culture and teaching strategies that address the unique needs of veterans both in and outside of the classroom. “Studies have shown the difficulty for veterans assimilating back into civilian life, getting a job and using the medical skills they developed in the military,” said Dr. Jene Hurlbut, professor and Roseman’s grant program director. “The grant enables the College of Nursing to build on the foundation of their military experiences with the nursing education curriculum and clinical experiences to develop them into nursing leaders.” Veteran students entering Roseman’s College of Nursing through the veteran's program may pursue either an 18-month on-campus BSN or a 16-month hybrid online Accelerated BSN, offered at the Henderson campus. Information about Roseman University College of Nursing programs can be found at www.roseman.edu. remEDy Summer 2016 | 31

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Charitable Gift Annuities: Give While You Receive You might think that saving for retirement and donating to your favorite charity are mutually exclusive—that donating to charity would take away from the money you have for retirement. The good news is that you can do good for yourself, and do good for the causes you care about with the right investment tools. Planning for the future doesn’t have to be at the expense of taking care of the things that mean the most to you today. Charitable gift annuities have become a popular investment option; unlike commercial annuities, these arrangements are part investment, part gift. Hundreds of non-profit organizations use these annuities to help raise money for a great cause while also helping the investor save for retirement. If this is the first you’re hearing about this investment option, it’s important to note that charitable gift annuities are not new. 32 | remEDy Summer 2016

By Rebecca Dukes

They were first introduced in the early 1920s, and then in 1927 the American Council on Gift Annuities (ACGA) was formed to help standardize the investments and provide educational and other services to charities who wanted to use them for fundraising. Today the ACGA lists 682 organizations as sponsors that offer charitable gift annuities. How CGAs Work To understand how CGAs work, we’ll use a gift to Roseman University as an example. When you set up a charitable gift annuity, you (as the donor) make a gift to Roseman University, giving the donor an immediate tax deduction. Roseman then invests the funds and, like any other annuity, the investment pays a stream of income throughout your lifetime. Anything that remains in the fund after you pass away (each gift annuity is a separate contract

with a defined gift amount) will be donated to Roseman University. Payments to you as the donor are based on your life expectancy, using IRS life expectancy tables and the most recent census data. Depending on your age, you will receive a certain percentage of the gift each quarter while simultaneously building, through the investment, a gift for an important not-for-profit like Roseman University in the future. There are many sophisticated, yet simple, gift arrangements like this that can help you achieve a dual goal of using your money wisely while you are alive and leaving a legacy when you are gone.

To find out more about these and other donation options, visit www.roseman.edu

ROSEMAN UNIVERSITY DENTAL STUDENT Chosen as Winner of National Research Event By Tracy Hernandez

The Student Clinicians of the American Dental Association (SCADA) honored Andrew Gross, a second-year student at Roseman University’s College of Dental Medicine, for his research submitted to the 2015 Student Clinician Research Program (SCRP). “This award is a great honor for any student in the competition and we are extremely proud of Andrew for his accomplishments,” said Dr. Frank Licari, dean of the College of Dental Medicine-South Jordan. “It is also meaningful for Roseman University because as a developing program people don’t expect our students to be able to compete with students from long-standing and well-established research programs at other dental schools. It speaks to the quality of our students and faculty, and the commitment we have made to excellence in education and research.” SCADA hosts this program each year to highlight elite-level student dentists who are participating in research at their individual dental schools. This year was the 56th annual event, and there were over 70 student clinicians, representing research from 39 countries, who submitted research for the competition. First-, second-, and third-place winners were chosen in the categories of Clinical Science/Public Health Research, and Basic Science Research. Gross was chosen as the first-place award winner in the basic science category for his research on chronic periodontitis. Specifically, Gross’ research looked at the activation and progression of Matrix-Metallo Proteinases (MMPs), which play a role in chronic and aggressive periodontitis. Chronic periodontitis is the second most prevalent oral health disease, affecting 47 percent of adults over the age of 30, and 70 percent of adults over the age of 65 in the U.S. alone. When the regular metabolic pathways for oral microbiota are disrupted, and they combine with toxins produced by bacteria in the mouth, it triggers an immune or inflammatory response that can lead to gum disease.

The goal of Gross’ research is to further clarify the mechanisms behind MMP activation, regulation, and dysfunction; characterize the pathways involved; and evaluate the efficacy of potential therapeutic targets to prevent or resolve chronic and aggressive periodontitis. Gross will also explore the possibility of working with researchers from Roseman’s pharmacy program to develop potential treatment options based on the research. “My project was up against well-funded, well-known labs,” said Gross. “To know that we have done this with a new program, it feels good and helps validate Roseman University as a research institution.” He received the award at a reception on November 7, 2015 at the Newseum in Washington, D.C. during the ADA’s annual session. As a first-place winner, he also got $750 and a travel package to present his research at the Hinman Dental Meeting in Atlanta, Ga. March 17-19. The SCRP began in 1959 at the centennial session of the American Dental Association (ADA) in New York City as a way to promote student research and encourage student participation in organized dentistry, and has remained a joint venture between the ADA and DENTSPLY International since that time. Initially it was a simple table clinic presentation where students could demonstrate new techniques, but today it has expanded to include more than 7,000 students participating in clinical and basic science research. Students who present research at the national level become members of SCADA, which means they may be eligible for fellowship funding that will help support their graduate education. More information about SCADA is available at www.scadaresearch.org.

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Alumni Spotlight: Jeffrey McMillan By Rachael Wadley

Not many people have fond memories of their days with braces, but for Dr. Jeffrey McMillan, a 2011 Advanced Education in Orthodontics and Dentofacial Orthopedics/Master of Business Administration (AEODO/MBA) program graduate, being an orthodontist provides him with the ability to make a difference and change peoples’ lives every day.

McMillan is a current resident and native to the Las Vegas area. He began his career as a dentist and soon realized that he could make a greater impact on peoples’ lives by becoming an orthodontist. “While working as a general dentist on an Indian reservation, I saw the vast need for orthodontics in populations that traditionally never had the ability nor the finances to access [it],” said McMillan. “I decided to focus my attention on these underserved populations in order to help them access care.” McMillan was initially drawn to Roseman’s three-year postdoctoral dental residency program that awards graduates with a Certificate in Orthodontics and Dentofacial Orthopedics as well as an MBA program due to its convenient location in the Las Vegas area as well as the MBA component. “Being able to stay at home was a blessing and I owe a tremendous amount of thanks to the current dean and program director, Dr. Pourhamidi, and the previous dean, Dr. Lynn Hurst, for the opportunity to be a part of the Roseman family,” said McMillan. “To date my greatest professional accomplishment has been obtaining an orthodontic certificate and MBA.”

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Roseman strives to make lifelong colleagues with all students that graduate from the University, hoping that each student will succeed not only professionally, but personally as well. “Roseman helped ingrain a confidence that anything is possible. It opened a door in the professional sphere that has allowed me to meet, communicate, and collaborate with professionals from all different realms of the health profession and business world,” said McMillan. “Even after graduation Roseman continues to foster my development in numerous avenues. Being able to reach out to a network of professionals for advice, guidance, and counsel has been invaluable.” McMillan was part of the second class of residents to graduate from the AEODO/MBA program, so he was able to experience the University’s past, and is still involved because he wants to be part of its future.

“One of the most fulfilling aspects of the Roseman experience has been the ability to grow within the University. Because it is such a young and thriving institution, there have been several opportunities to work with the University on deepening it roots, not only here in my native home, but throughout the region,” said McMillan. McMillan’s favorite moment while a resident at Roseman was the building of the orthodontic clinic. He remembers stepping into the new orthodontic clinic and seeing the vision of a number of individuals come to fruition. “The time, planning, money, effort, and energy culminated at that particular instant,” said McMillan. The space had been transformed from the first time he saw it as an empty shell with dirt, concrete, and wires everywhere, to a state-of-the-art clinic for patients.

“Going from that to one of the most, if not the most, state-of-the-art facilities in the country was nothing short of remarkable,” said McMillan. After McMillan graduated from the AEODO/MBA program, he accepted a full-time orthodontic position with a growing company that was Medicaid driven. He recently accepted a position as the clinical orthodontic director of a national dental service organization and is also working on opening a few offices in the southern part of the United States. When McMillan isn’t changing lives with orthodontic treatment, he enjoys traveling, running and politics, and likes to study the financial, economic, political and health impact of sugar in the world. McMillan currently serves on the Roseman MBA Advisory Board, Roseman Medical School Diversity & Inclusion Advisory Board, and is a member of several organizations

such as Academy for Sports Dentistry, American Association of Orthodontists (AAO), World Federation of Orthodontists (WFO), and the National Dental Association (NDA). He has allowed his experiences at Roseman to positively impact not only his life, but the lives of those patients he treats. If he could give any advice to current Roseman students he would encourage them to broaden their horizon during their tenure. “Sometimes we get so focused on getting our certificate to go out and finally make a living we miss so many opportunities that we might have passed up,” he said. “Being able to step back and try to determine all of the different avenues that may be available is well worth the time.”

“Going from that to one of the most, if not the most, state-of-the-art facilities in the country was nothing short of remarkable,”

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Student Advocacy AND Legislative Day Conference:

A Student’s Perspective By Salwa Naim, Second-Year Pharmacy Student

From the moment I set foot onto Roseman University’s campus as a College of Pharmacy student, I made sure to expose myself to available opportunities that enhanced my knowledge on the profession of pharmacy. This ranged from multiple training workshops to health fairs, seminars, and speaker series events, to name a few. Legislation is an area that has also been a long-standing interest of mine. Lawmaking is one platform where I always felt awareness was critical and change was very possible. All it required was a capable voice. Accordingly, my passion towards advocacy is rooted in the belief that it is essential for change to come. Advocacy opens doors to protect legislation that works and create amendments for the legislation that could work better. When I discovered ASHP’s Student Advocacy and Legislative Conference, I jumped at the opportunity to combine my love of legislation and advocacy with the opportunity to increase my knowledge of legislation’s effect on my chosen profession (all with the added benefit of representing my university). More than 50 students from across the United States representing various pharmacy colleges were in attendance at the ASHP’s Student Advocacy and Legislative Day Conference in Washington, D.C. (they called it “SSHPTakesDC16”) for a two-day conference. Although the students were mainly upperclassmen with a vast array of advocacy experience, even those without much experience had a passion for driving change through targeted leadership. Multiple sessions expertly run by ASHP’s Federal Legislative and Political Engagement Directorship included an overview of political advocacy and background information on issues affecting pharmacy, pharmacists and pharmacy students, most of which focused on provider status legislation. This included an in-depth look into and discussion of the Pharmacy and Medically Underserved Areas Enhancement Act (HR 592/S. 314), followed by advocacy and lobbying workshops. 36 | remEDy Summer 2016

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The following day I headed to Capitol Hill along with fellow student Sebastien Arziari and ASHP staff member Dr. Allie Woods to educate Nevada Senators Dean Heller and Harry Reid and their staff on provider status, its importance to the pharmacy profession, healthcare providers and patients, and its national implications. We showcased the many benefits from pharmacists being involved at the front end of the healthcare chain with early intervention, then discussed the extent of our training, including early exposure to direct patient care via the experiential program and field specialization; our current unrecognized practices within hospitals; our underutilization as qualified healthcare professionals; and our data-driven ability to curb some preventable situations that result in poor patient outcomes. We also talked about the steady and widening gap of unmet needs due to a decreasing number of primary care providers at the same time millions of newly eligible patients are entering the healthcare system, the impacts of which are most severe on patient populations in underserved areas. We highlighted the concern about skyrocketing healthcare costs, and discussed how provider status could curb some repeated costs by simply incorporating pharmacists into the healthcare model. Each congressional office told us that support of the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314) aligned with the interests of their respective offices and was beneficial in serving the general public with quality care to an accessible, qualified healthcare professional while reducing the government’s overall costs long term. As the meetings ended we asked for their co-sponsorship of S. 314.

Attending the conference, including the training prior to the conference, personally reinforced the importance of utilizing our voices as future healthcare professionals, and I look forward to continuing my advocacy for pharmacists, patients, and healthcare in general while I am a student and after graduating. Being faced with these glaring issues plaguing our healthcare system, pharmacists are the undeniable solution in their capability to play a much larger role in delivering healthcare services. This is not inclusive of the broad range of services they already provide around the nation. To be unhealthy, not by choice, is something that affects every aspect of an individualâ&#x20AC;&#x2122;s life. In addition to having poor health, to also have a quality healthcare professional be out of your reach due to specific wording and/or exclusion from a law is inexcusable. Furthermore, to discount the overwhelming clinical value pharmacists have is truly irresponsible. Choosing to be a healthcare professional necessitates the desire to be vested in a patientâ&#x20AC;&#x2122;s life, bestowing unbiased compassion, and taking great care to use every facet of our training to explore every possible avenue of treatment to improve the quality of another human beingâ&#x20AC;&#x2122;s life. To be able to carry out our purpose in serving our patients, it becomes our obligation to educate, inform and advocate for change. We took an oath to speak up for patients when their voices simply cannot be heard. This experience has deepened my resolve to step in as an advocate for the profession I believe in, have committed to and am investing in.

The face of healthcare is changing, and those unwilling to move with the tide will undoubtedly be left behind. So, our role becomes an even more important one. As the young professionals of tomorrow, we must be engaged in the future of our profession by defining the landscape and shaping the trajectory of those paths today. Policymaking is important; its effect touches every one of us in some form. It becomes the responsibility for each one of us to be aware of impending legislation, any rules and regulations which affect where we practice, what the scope of our practice is or how we deliver our service(s) to the general public. Join me in taking the driver's seat to exact what we want to see happen in our profession. Become involved by effectively promoting pharmacy specific legislative issues. We are the best indicators of what the definition of pharmacy is and the best judges of the scope of our varied abilities. Let us each, pharmacist and student pharmacist alike, take charge in being the ones who define the guidelines of our practice and the direction of our profession. The time is now.

Action is what will push movement forward. My objective is to strengthen, perpetuate, and extend interest in moving my fellow classmates to seize presented opportunities to make their voices heard while enhancing the perception of a pharmacist. My hope is to inspire others to reinforce this message throughout the community and with advocacy on a state level. I have learned that as students, we have a large amount of credence that ties into our dual role as constituents. We are a large part of the fabric that composes the pharmacy community. Divided, we will not accomplish much, if anything. In unison, however, we are poised to meet the challenges head on. As the next generation of pharmacists, we are trained with the latest and greatest resources available. The fluidity of pharmacy makes this profession expansive, moving into various forums as it will continue forging new paths.

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2nd Annual Research Symposium Highlights Roseman Research Projects By: Tracy Hernandez

It is only the second year that Roseman University has hosted a Research Symposium, but this year’s event was a tremendous success. Building on the groundwork from last year, the 2016 Symposium featured more than 100 posters and podium presentations from student and faculty researchers at all three of Roseman’s campuses in Summerlin and Henderson, Nev. and South Jordan, Utah, as well as research from Touro University in Henderson, Nev. Keynote Speakers: Translational Research The event began with keynote presentations at each campus on the topic of Translational Research by Dr. Jane Dyer in South Jordan and Dr. Melanie Nicol in Henderson. Dr. Dyer is the Belle S. Spafford Endowed Chair at University of Utah in the College of Social Work and the Vice Presidential Clinical and Translational Scholar in the College of Nursing. Dr. Nicol is an Assistant Professor in the Department of Experimental and Clinical Pharmacology at the University of Minnesota. Both spoke about the importance of translational research and its impact on patient populations by being able to get potentially life-saving research from the bench and laboratory to the real world sooner. Right now the average amount of time that it takes for a breakthrough discovery to get from the laboratory to patients is about 17 years, according to Dr. Dyer, so translational research efforts aim to reduce that gap. Interprofessional Research Panel Following the keynote, Roseman University faculty participated in a panel to discuss the future of interprofessional research and education, highlighting the opportunity that we have as an institution to encourage students and faculty to conduct research with others outside of their academic unit and with partners in the community, which will bring in new perspectives and position them for grants and funding opportunities that are increasingly available for multi- and cross-disciplinary research projects. 38 | remEDy Summer 2016

In Henderson the panel included: • Dr. Prashanti Bollu, Director of Dental Research and Assistant Professor, College of Dental Medicine-Henderson (moderator) • Dr. David Rawlins, Assistant Professor of Pharmaceutical Sciences, College of Pharmacy • Dr. Christopher Burns, Associate Professor of Biomedical Sciences, College of Medicine • Dr. Jene Hurlbut, Professor, College of Nursing • Dr. Kishore Chaudhry, Research Associate Professor, College of Medicine In South Jordan the panel included: • Dr. Frank Licari, Dean of the College of Dental Medicine-South Jordan (moderator) • Dr. Aaron Ferguson, Director of Public Health Sciences Education and Assistant Professor, College of Dental Medicine • Dr. Casey Sayre, Assistant Professor, College of Pharmacy • Nena Schvaneveldt, Head Librarian and Reference and Instruction Librarian, South Jordan campus

POSTER PRESENTATIONS There were 41 poster presentations from students and faculty at Roseman University and Touro University at the Henderson campus. In addition, there were eight podium presentations with a variety of topics in the areas of science and educational research: • Ranjana Mitra, PhD – Role of lipid metabolism genes DGAT1 and ABHD5 in prostate cancer growth • Shaun Nolette, PharmD/MBA Candidate 2017 – Zerumbone inhibits growth of paclitaxel resistant ovarian cancer cells by inhibiting Jak2/Stat3 signaling pathway • Jessica Yang, DO Candidate, Touro University – Phenotypic Characterization of Pain Relieving NSAID-Serotonin Conjugates In Vivo • Sanford H. Barsky, MD – A Metastasis Caught in the Act: A Proposed Mechanism for Lymphovascular Invasion of Human Breast Cancer • Krystal Riccio, PharmD, BCACP – Evaluating student success and confidence to Choose All That Apply questions • Stephanie Wragg, PhD – Adapting elements of a comprehensive leadership training program to reach a greater audience via conference workshops • Marie Wright, EdD, MSN, RN – Predictors of student success in block immersion, mastery learning BSN program • April Cole, DDS, AEODO/MBA Resident 2016 – The Economic Feasibility of Pursuing Post-Doctoral Education in Orthodontics In South Jordan, students and faculty from Roseman University submitted 55 posters and four podium presentations: • Nishika Patel, PharmD Candidate 2016 – Potential Bromocriptine-induced mania in a patient being treated for a pituitary tumor • Derek Dutson, DMD Candidate 2017 – Gingival epithelial cells exposed to cigarette smoke extract induce RAGE-mediated inflammation • Allen Le, Jalee Farr, PharmD Candidates 2016 – Time and cost savings of implementing an automatic renal dosing protocol • Venkata Yellepeddi, PhD – Population pharmacokinetics of Amikacin in pediatric oncology patients WINNERS The event included judges who reviewed poster presentations for visual presentation, scientific merit and clarity of the research, and oral presentation. Winners were chosen at each campus and received a certificate of recognition and a prize. Henderson winners: • Best Resident presentation – Dr. Myat Htut, DDS • Student presentation, 1st place – Daniel Dilanji (Advisor – Dr. Arup Chakraborty, COP) • Student presentation, 2nd place – Todd Nagamine (Advisor- Dr. Chris So, COP) South Jordan winners: • Bench Science, 1st place – Nate Harward, College of Dental Medicine • Bench Science, 2nd place (tie) – Justin Durrant, College of Dental Medicine and Annh Vo, College of Pharmacy • Clinical Science, 1st place – Megan Corsi, College of Pharmacy • Best Practices, Descriptive, 1st place – Danielle Nguyen, College of Pharmacy • Best Practices, Evaluative, 1st place – Debbie Beckstrom, College of Pharmacy • Best Practices, Evaluative, 2nd place – James Le, College of Pharmacy Thank you to EISC Lab Data Automation for their generous sponsorship for the Research Symposium awards and their recognition of our students’ research achievements. To see more information about the poster presentations, and view photos from the event, visit www.roseman.edu.

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Roseman NCPA C in South Jordan

Raises Money R for Utah Refugees By: Lindsay Hammeren, Second year Pharmacy Student

Many Roseman faculty and students probably remember last year’s National Community Pharmacists Association (NCPA) 5K, Be Somebody’s Hero, when students, faculty and the community came together to raise money for the Huntsman Cancer Institute. It was a great event, and when it came time to plan this year’s 5K, we knew that the first step was to decide the cause for which we wanted to raise money and awareness.

Roseman created the #ColorMeRefugee 5K run to raise money for a group therapy program at the Utah Refugee Center. We decided to make it a color run as a symbolic way to celebrate the hope and opportunity in the lives of Utah refugees, despite their trials. The race consisted of a 1K children’s fun run and a 5K run. Despite the wind and cold weather, students, faculty, and members of the community came out to support Utah refugees.

Recent world events, political discord, and terrorist attacks have turned our minds and our hearts towards the refugees of the world, and as we began researching different causes, we learned that Utah receives the largest volume of refugees per state in the entire country. This led us to our partnership with the Utah Refugee Center and its executive director, Deb Coffey, who helped us figure out the best way for our student organization to assist our local refugees.

After the 5K, students and faculty hosted a health fair that included a brown bag event sponsored by Roseman’s Academy of Managed Care Pharmacy (AMCP) student chapter, a Drug Take-Back Event sponsored by Roseman’s Drug Abuse Awareness Team (DAAT), a blood drive, and health screenings sponsored by Roseman’s NCPA student chapter.

There is a large gap in the healthcare of these refugees, especially access to mental counseling and therapy, according to Coffey, so the NCPA student chapter at

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We kicked off our awards ceremony with friends from the Utah Refugee Center, including two Utah refugees who came to share their stories of trial and success with us. Roseman faculty had the opportunity to sponsor teams of students again, with faculty trying to beat last year’s winners

from Dr. Larry Fannin’s team (Campus Dean of the Roseman College of PharmacySouth Jordan), who won a free trip to Applebee’s. This year Roseman’s very own Dr. Pence was the first to finish the 5K which meant that he and the student team he sponsored won a free dinner at Buffalo Wild Wings. Winners of the children’s fun run also received prizes, including day passes to Boondocks. The NCPA chapter ultimately raised over $3,000 at this year’s event. Thanks to our runners and community sponsors, the Utah Refugee Center will be able to further the important work of helping our refugees successfully assimilate to their new community. We are grateful to have been a small part of the efforts to aid in this project. Anyone interested in helping the Utah Refugee Center can find information at utahrefugee.org/make-a-contribution or check out their new app, Serve Refugees, (available in the App Store and on Android) to find ways you can serve and give to refugees in Utah.

OUR PEOPLE

our

PEOPLE October 2015 to May 2016

NEW EMPLOYEES College of Nursing Henderson Campus • Amy Chaffin, Adjunct Faculty • Habtamu Egata, Adjunct Faculty • Judith Elkins, Assistant Professor • Michelle Hudders, Adjunct Faculty • Claudette Lachowicz, Adjunct Faculty • Leida Meek, Adjunct Faculty • Maheswari Nadarajan, Adjunct Faculty • Anja Ryssaert, Administrative Assistant • Siboney Zelaya, Adjunct Clinical Faculty College of Nursing South Jordan Campus • Ashley Arias, Adjunct Faculty • Amber Barrus, Adjunct Faculty • Shanda Clark, Adjunct Faculty • Beth Green, Adjunct Faculty • Natalie Maughan, Adjunct Faculty • Kiley North, Admissions Specialist

College of Pharmacy Henderson Campus • Vasudha Gupta, Assistant Professor of Pharmacy Practice • Chike Okolo, Assistant Professor of Pharmacy Practice • Velliyur Viswesh, Assistant Professor of Pharmacy Practice

College of Pharmacy South Jordan Campus • Cameron Gordon, Instructor/Resident • Phillip Lawrence, Assistant Professor

College of Dental Medicine Henderson Campus • Kishore Chaudhry, Research Associate Professor

our people

remEDy Summer 2016 | 41

our

PEOPLE

College of Dental Medicine South Jordan Campus • Melissa Bracken, Dental Assistant – Sterilization • Todd Bowman, Adjunct Faculty • Katie Cooper, Dental Assistant – Dispensary • Ali Dawood, Adjunct Faculty • Andrew Gross, Postdoctoral Research Associate • Stephanie Harrington, Communication Receptionist • Charles Miller, Adjunct Faculty • Laura Pena, Communication Receptionist • Memorie Stanton, CPT Scheduler • Kim Ngoc Ta-Huynh, CPT Scheduler • Richard Watt, Adjunct Faculty

College of Medicine Summerlin Campus • Karen Crouch, Administrative Assistant for Clinical Affairs • Jennifer Haley, Executive Administrative Assistant • Susan Heltsley, Assistant Dean for Finance and Administration • Alan Lin-Greenberg, Chair and Professor of Internal Medicine • Jayabala Pamidimukkala, Associate Professor of Biomedical Sciences • Steven Peralta, Director of Philanthropy • Mira Sarsekeyeva, Associate Professor of Ob-Gyn

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(cont.)

MBA Program • Scott Allred, Adjunct Faculty • Paula Castillo, Administrative Assistant • Eric Dow, Adjunct Faculty • Tobi Falzon, Adjunct Faculty • Bruce Lazar, Adjunct Faculty • Brian Provenzano, Adjunct Faculty • Larry Rodis, Adjunct Faculty

Service Units Henderson Campus • Saralyn Barnes, Director of Human Resources • Bralyn Beathea, Financial Aid Counselor • Richard Beck, Director of Facilities • Hilda Goodman, Receptionist • Eric Jones, Art Director • Kenia Pardo-Moscoso, Accountant • Melissa Smith, Library Assistant Service Units Summerlin Campus • Jonathan Bay, HR Generalist • Vernon Dew, Facilities Technician Service Units South Jordan Campus • Benjamin Bolin, Collection Management Librarian • Colton Van Beuge, Help Desk Tech I

reimagine Y O U R

S M I L E

A healthy, beautiful smile doesn’t have to be out of reach for you and your family. Fortunately the residents and student dentists at Roseman’s orthodontic and d e n t a l c l i n i c s h ave p rov i d e d k i n d , affordable care to Nevada and Utah pati en t s s in ce ou r f i rst cl i ni c o p e ne d i n 20 07. I f you want a he al t hi e r, m o re beautiful smile for yourself or a family me m b er, vis it u s to d ay !

Orthodontics (Nevada): rosemanbraces.com Comprehensive Dental Care (Utah): rosemandental.com Challenge. Reimagine. Roseman.

COLLEGE OF DENTAL MEDICINE COLLEGE OF NURSING

COLLEGE OF MEDICINE

COLLEGE OF PHARMACY

MASTER OF BUSINESS ADMINISTRATION

@rosemanuhs

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Roseman University of Health Sciences A Nevada Non-Profit Corporation 11 Sunset Way Henderson, NV 89014-2333

ROSEMAN UNIVERSITY and LIBERTY MUTUAL 17TH ANNUAL SCHOLARSHIP GOLF TOURNAMENT Monday, Oct. 3 at Bear’s Best Las Vegas Love to golf and want to make a difference in the lives of students? Roseman University’s Annual Golf Tournament has raised over $1 Million to support student scholarships! Don't Golf? Come To Dinner & Meet Our Scholarship Recipients. To learn more visit www.roseman.edu/golf or call 702-802-2870

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