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Research Newsletter Department of Geriatrics Florida State University College of Medicine In This Issue New Projects & Collaborations 2-3 Community Involvement 3 Senior Artist Project 3, 4 Updates/Findings 4-5 Awards 6 Announcements 7 Presentations Publications Notes of Interest Geriatrics Faculty Members Featured in Updated Reference Book 7-9 9-10 10 Want to Give to the Department? Go to http://one.fsu.edu/page.aspx? pid=625 to find out more about the types of gifts you can give and their impact. You can give online, through electronic funds transfer, by phone, or by mail. Ham’s Primary Care Geriatrics, sixth edition, is a medical reference book that features an interdisciplinary perspective that provides team-oriented knowledge on the best diagnosis, treatment, and management strategies available to address the complex needs of older adults. If you have questions, call the FSU Foundation at (850) 644-4389 or (850) 644-3353. Chapter authors, from left: Alice Pomidor & Ken BrummelSmith. Not pictured: Lisa Granville, Niharika Suchak, and Debra Danforth. March-July 2014 FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] New Projects & Collaborations Investigating the HeartMath Technology to Reduce Stress in Medical Students Ken Brummel-Smith, M.D. This study will test to see if the HeartMath technology can help medical students reduce their stress levels. HeartMath is a validated technique that uses cardiac biofeedback to determine heart rate variability (HRV). High HRV has been shown to be associated with low levels of stress hormones such as epinephrine and cortisol. A number of studies using HeartMath have shown benefits in test anxiety in high school students but none have yet studied medical students’ stress levels. Jason was awarded a Charles R. Mathews Scholarship for Geriatrics Education and Research to assist Dr. Brummel-Smith on this summer research project. Read more about Dr. Mathews. Jason Lesnick, Class of 2017 MUST-SIT together©: An Interprofessional Education Model Niharika Suchak, M.D. in collaboration with Debra Danforth, M.S., A.R.N.P., F.A.A.N.P., Maria Whyte, M.S.N., D.H.Sc., A.R.N.P. (Nursing), and Jean Munn, Ph.D., M.S.W. (Social Work) Most healthcare educational institutions in the U.S. are planning or implementing interprofessional education competencies in their curricula for their learners. The Modified Use of Simulation in Teams for Students in Training (MUST-SIT) together© model was designed to gather students from four healthcare disciplines (medicine, nursing, pharmacy, and social work) together in the same physical space and to introduce them to the core concepts of interprofessional teamwork and team-based care. The investigators are currently reviewing retrospective survey and observational data. Marielys Figueroa-Sierra, Class of 2016 Page 2 Marielys was awarded a scholarship from the Mina Jo Powell Fund for Study of Health Issues in Aging for her assistance with this educational research study. Read more about Ms. Powell. FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] New Projects & Collaborations Florida Longitudinal Study of Aging Antonio Terracciano, Ph.D. and Angelina Sutin, Ph.D. The Florida Longitudinal Study of Aging is a multidisciplinary longitudinal study that will explore changes in the health and wellbeing of older adults in retirement communities. Drs. Terracciano and Sutin are leading this study and providing research experience to undergraduate and graduate FSU students. Antonio Terracciano, Ph.D. The study includes a wide range of measures. Clinical measures include a medical history, cognition, depressive symptoms, height and weight, blood pressure and pulse, and peak expiratory flow. Participants are also asked to wear an activity monitor for one week and to complete a physical assessment to measure their physical fitness and sleep patterns. During a taped interview, participants also talk about memories of personally meaningful experiences. In-depth psychological assessments are also conducted through a take-home survey. This study began recruiting from Westminster Oaks in April. Since then, approximately 40 participants have been tested and interviewed. Angelina Sutin, Ph.D. Community Involvement The Department thanks the following community organizations for their partnership. Allegro Casa Calderon Lake Ella Manor Tallahassee Memorial HealthCare Memory Disorders Clinic Tallahassee Senior Center Westminster Gardens Westminster Oaks Page 3 Lilies on the Lake by Nancy Juster Johnson Project sponsored by a Donald W. Reynolds Foundation grant. FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Updates/Findings Uric Acid and Neuropsychiatric Symptoms in Individuals with Cognitive Impairments Antonio Terracciano, Ph.D. Lauren Stewart, Class of 2018 Katy Willbur, M.S. This project aims to investigate whether agitation-related symptoms in people with dementia are associated with uric acid levels. Read more... During her time on the project, Lauren Stewart started recruiting participants and paving the way for more in-depth data collection. She presented her findings at the Bridge Luncheon in May. Peruvian Drop Spindle by Nancy Juster Johnson Research assistant Katy Willbur continues to recruit and interview participants for this study. Medication Use Among Residents of a Residential Memory Care Unit Lisa Granville, M.D. Mauricio Parra-Ferro, Class of 2018 This study aimed to analyze the existing medication profiles of the facility’s residents. Read more... Research assistant Mauricio Parra-Ferro presented his findings from the study at the Bridge Luncheon in May. In his presentation, he showed that residents were taking an average of eight medications and 71.4 percent of the residents were on at least one potentially inappropriate medication. Of the 227 medications reviewed, 33 were listed as potentially inappropriate according to Beers Criteria. While these medications were spread across various therapeutic drug categories, there was a considerably higher prevalence of psycholeptics. The high prevalence of potentially inappropriate medications found in this and other studies supports the idea that healthcare professionals have an opportunity to lead the way in the implementation of safer, potentially non-pharmacological interventions for various conditions in vulnerable older adults. Page 4 FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Updates/Findings Exploring Depression in Older Adults Suzanne Baker, M.A. and Angelina Sutin, Ph.D. Stephanie Poteau, Class of 2018 Tamara Marryshow Granados, Class of 2017 This project aims to better understand the stigma of depression among older adults in our community in order to identify diagnosis and treatment barriers. Read more... Research assistant Stephanie Poteau presented her findings from the study at the Bridge Luncheon in May. Tamara Marryshow Granados was awarded a Charles R. Mathews Scholarship for Geriatrics Education and Research. This summer she has continued to recruit participants from five community sites, distribute surveys, and interview participants. To date, 89 persons age 65 and older have participated in the survey portion of the study and 39 have also completed interviews. The mean age of respondents is 72.5 years and 70 percent are female. In terms of the association between personality and depression, the data thus far follow the existing literature that more depressive symptoms are significantly associated with higher levels of Tamara Marryshow Granados, neuroticism and lower levels of extraversion, conscientiousness, Class of 2017 and agreeableness. In terms of stigma, participants generally do not think poorly of people who suffer from depression. They do recognize that it can cause interpersonal problems (i.e., trouble in a marriage), but people with depression should not have to hide it or feel bad about it. When asked how likely it would be that they would seek help from various sources if they experienced depression, the greatest percentage of participants (35 percent) said they would be very likely to talk to their doctor, and 34 percent indicated it would be very likely that they would modify their lifestyle (i.e., diet and exercise), as compared to 25 percent who said they would talk to a mental health professional and/or take an antidepressant. Only 12 percent indicated that they would be very likely to talk to a clergy member, church leader, or spiritual guide. Data analysis is ongoing. Page 5 FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Awards Florida Geriatrics Society Outstanding Student in Geriatrics Award Mary O’Meara Brett Thomas On behalf of the Department, Dr. Myra Hurt awarded Brett Thomas and Mary O'Meara the Florida Geriatrics Society Award for Outstanding Student in Geriatrics. This award is presented to the senior medical student who uses a patient-centered approach to problem solving and patient management for the older adult and who recognizes the distinct benefit this approach gives the older patient, their family, and caregivers. Dr. Pomidor Named a Fellow of the American Geriatrics Society “AGS Fellowship status (AGSF) is awarded to AGS members who have demonstrated a professional commitment to geriatrics, contributed to the progress of geriatrics care, and are active participants in the Society's activities. Attaining AGSF status places members in a specially recognized group of healthcare providers who are dedicated to geriatrics education, clinical care, and research, as well as to their own continuing professional development. Fellows have distinguished themselves among their colleagues, as well as in their communities and in the Society by their service. Their dedication and longstanding commitment to AGS is recognized by this mark of distinction.” Alice Pomidor, M.D. Page 6 - American Geriatrics Society FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Announcements Ken Brummel-Smith, M.D. will teach the Osher Lifelong Learning Institute’s (OLLI) New Concepts in Medical Care. Classes through OLLI are offered to adults age 50 or older. This class will address new concepts and discoveries in how medical care is practiced in America. The class will begin October 1 and be held Wednesdays from 2:00-4:00 p.m. at Westminster Oaks Maguire Center. Read more... Alice Pomidor, M.D. will serve as the Chair of the Public Education Committee of the American Geriatrics Society for a term beginning May 2014 and ending May 2017. She will also serve a concurrent term on the Steering Committee for AGS committees. Presentations American Geriatrics Society Lunch and Learn In June, the Department hosted another American Geriatrics Society Lunch and Learn. During this event, faculty presented topics that were discussed at the annual meeting in May. The goal of the event is to disseminate important, national information on geriatric care. This year’s topics included: Update on and Demonstration of e-Learning Resources: MOOCs, WebGEMS, and SpacedEd, presented by Alice Pomidor, M.D. New Choosing Wisely Recommendations— Improving Care for Geriatric Patients, presented by Ken Brummel-Smith, M.D. Heart Failure as a Geriatric Syndrome, presented by Ken Brummel-Smith, M.D. Designing Better Surveys, presented by Suzanne Baker, M.A. Faculty development credit was available to those who attended. The recording and presentation materials can be viewed on the Faculty Development website. Page 7 2014 Florida Geriatrics Society Annual Meeting Agens J, Baker S, and Friedman E. A Pilot Study of Fourth-Year Medical Student Charting of Cognitive and Functional Status in Older Persons. Agens J, Quintero S, Tsilimingras D, and Lee H. Post-Discharge Adverse Events of Individuals Age 65 and Older. Gardner L, Siefman M, Brummel-Smith K, Baker S, Edgerton L, and Menkin E. Consistency of Choices of End-of-Life Wishes Using the “Go Wish” Cards: A Comparison of Elders with Intact Cognition and Mild Cognitive Impairment. Suchak N, Figueroa-Sierra M, Danforth D, Whyte M, and Munn J. MUST-SIT together©: An Interprofessional Education Model. FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Presentations 2014 American Geriatrics Society Annual Meeting Marielys Figueroa-Sierra, Debra Danforth, Maria Whyte, Jean Munn, and Niharika Suchak. Modified Use of Simulation in Teams for Students In Training (MUST-SIT)©: An Interprofessional Education Model. Antonio Terracciano and Angelina Sutin. Personality Links with Chronic Obstructive Pulmonary Disease. Hanna Lee, John Agens, Stephen Quintero, and Dennis Tsilimingras. Jason Gronert, Lisa Granville, Suzanne Baker, and LaVon Edgerton. Hospital Post-Discharge Adverse Events of Individuals Age 65 and Older. Understanding Lower Urinary Tract Symptoms (LUTS) and Their Impact on LifeSpace in Older Adults. Page 8 FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Presentations Marshall Kapp, J.D. “Home- and Community-Based Long-Term Care Services and Supports: What Does Health Reform Have to Do With It?” at Health Reform, Transition, and Transformation in Long-Term Care, the 26th Annual Health Law Symposium sponsored by the Saint Louis University School of Law, Center for Health Law Studies, in St. Louis, MO, March 28, 2014. “Making Medical Practice More Rational: Does the Law Help or Hurt?” at the 37th Annual Health Law Professors Conference of the American Society of Law, Medicine and Ethics, San Francisco, CA, June 7, 2014. Niharika Suchak, M.D. “Modified Use of Simulation in Teams for Students In Training (MUST-SIT together)©: An Interprofessional Education Model” at The International Nursing Association for Clinical Simulation & Learning conference in Orlando, FL, June 10-13, 2014. Debra Danforth, Maria Whyte, Niharika Suchak, Jean Munn, and Marielys Figueroa-Sierra. Publications Arjmandi BH, Ormsbee LT...Brummel-Smith K, et al. A Combination of Scutellaria Baicalensis and Acacia Catechu Extracts for Short-Term Symptomatic Relief of Joint Discomfort Associated with Osteoarthritis of the Knee. Journal of Medicinal Food. 2014;17 (6):707-713. Leipzig RM, Sauvigné K, Granville LJ, et al. What Is a Geriatrician? American Geriatrics Society and Association of Directors of Geriatric Academic Programs End-of-Training Entrustable Professional Activities for Geriatric Medicine. Journal of the American Geriatrics Society. 2014;62(5):924-929. O’Shea J, Brummel-Smith K, Baker S, and Edgerton L. Milestone or Millstone: Medicare Access in Midsize Metros. Clinical Geriatrics. 2014. Kapp MB and Brummel-Smith K. My View: Wishes Can Become Comforting Mandates for Patients. Tallahassee Democrat. 2014. Atkinson HH, Tan ZS...Granville L. A collaborative national model to assess competencies for medical students, residents, and other healthcare practitioners in gait and falls risk evaluation. Journal of the American Geriatrics Society. 2014;62 (6):1155-1160. Page 9 Kapp MB. Book Review of “Caring and the Law” by Jonathan Herring, in Care Management Journals. 2014;15(2):98-99. Kapp MB and Nair-Collins M. “Impaired Professionals,” in Bioethics (4th ed.), Bruce Jennings, ed. Farmington Hills, MI: Macmillan Reference. 2014;3:1628-1631. FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected] Publications Kapp MB. “Aging and the Aged: Research Ethics,” in Bioethics (4th ed.), Bruce Jennings, ed. Farmington Hills, MI: Macmillan Reference. 2014;1:129-131. Kapp MB. I’m Getting Turned Off: Emerging Consensus on Deactivating Cardiac Implantable Electronic Devices. Medicine and Law. 2014;33(1):14-21. Loeckenhoff CE, Chan W...Terracciano A. Gender Stereotypes of Personality Universal and Accurate? Journal of Cross-Cultural Psychology. 2014;45(5):675-694. Milaneschi Y, Sutin AR, Terracciano A, et al. The Association Between Leptin and Depressive Symptoms is Modulated by Abdominal Adiposity. Psychoneuroendocrinology. 2014;42:1-10. Terracciano A. Pregnancy, Marriage, and Quitting School Nurture Personality Development? Commentary on Bleidorn, Klimstra, Denissen, Rentfrow, Potter, and Gosling. Psychological Science. 2014;25 (4):1049-1050. Terracciano A, Strait J, Scuteri A, et al. Personality Traits and Circadian Blood Pressure Patterns: A 7-Year Prospective Study. Psychosomatic Medicine. 2014;76 (3):237-243. Terracciano A, Sutin AR, An Y, et al. Personality and Risk of Alzheimer's Disease: New Data and Meta-Analysis. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 2014;10(2):179-186. van den Berg SM, de Moor MH...Terracciano A, et al. Harmonization of Neuroticism and Extraversion Phenotypes Across Inventories and Cohorts in the Genetics of Personality Consortium: An Application of Item Response Theory. Behavior Genetics. 2014;44(4):295313. Turner G. Critical Synthesis Package: Effectiveness of Evidence-Based Practice Teaching Questionnaire (EBPTQ). MedEdPORTAL. 2014. Notes of Interest The Alzheimer’s Project Watch Momentum in Science. "Momentum In Science is a two-part state-of-thescience film that takes viewers inside the HBO and the National Institute laboratories and clinics of 25 leading scientists and on Aging's Alzheimer's disease physicians, revealing some of the most cuttingresearch program have collaboedge research advances.” rated to raise awareness of the "scientific discovery, research Watch The Memory Loss Tapes. advances and challenges, and There are four documentaries, the first is titled of the human faces behind the "The Memory Loss Tapes." This video “provides an disease." up-close and personal look at seven individuals living with Alzheimer's, across the full spectrum of the progression of the disease.” Page 10 FSU College of Medicine - Department of Geriatrics 1115 West Call Street, Suite 4300, Tallahassee, FL 32306-4300 (850) 645-8440 [email protected]