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Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

Development And Validation Of A Process Focused Measure Of Childhood Depression, Ida Babakhanyan

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this research was to develop a measure of childhood depression and test its psychometric properties with depressed and non-depressed children. First, an overview of our current understanding of childhood depression and the measures used in assessment is reviewed. Following, the problems with our diagnostic classification are presented, providing justification for the development of a new measure for childhood depression. A bottom-up approach is used in this study to develop a theory driven measure for identifying depression in children which focuses on the process. Thus, varying from the primarily symptom based assessment tools that are currently used in …

Attributions For Interpersonal Healthcare Mistreatment And Continuity Of Care, Daniel Joel Northington

Loma Linda University Electronic Theses, Dissertations & Projects

Although continuity of cancer-related care increases the use of early detection cancer screening exams (Doescher, Saver, Fiscella, & Franks, 2004), and thereby improves treatment outcomes (Mandelblatt et al., 2009), Latino (Latina) women in the U.S. currently report lower continuity of care than non-Latino White (Anglo) women (American Cancer Society, 2010; Doescher, Saver, Fiscella, & Franks, 2001). Such disparities may be due, in part, to interpersonal healthcare mistreatment (Smedley, Stith, & Nelson, 2003), as well as mistreatment-related attributions and emotions (Betancourt, Flynn, & Ormseth, 2011; Tucker, 2008). Therefore, according to Weiner's model of attribution and emotion (1986) as well as Betancourt's …

Cultural Study Of Attributions Of Sports Fans, John C. Park

Loma Linda University Electronic Theses, Dissertations & Projects

Cultural differences in the attributions of sports fans in the US have not been sufficiently explored. Studies have shown that individualists have the tendency to make more internal attributions compared to collectivists (Kashima & Triandis, 1986; Al-Zahrani & Kaplowitz, 1993; Cha & Nam, 1985; Hallahan et al., 1997). Furthermore, in sports setting, individualists have the tendency to engage in the self-serving bias, whereas collectivists may not engage in this process (Schuster et, al, 1989; Lee et. al, 1996; Hallahan et. al, 1997; Crittendon, 1991). Undergraduate students at La Sierra University, California, participated in an experiment where cultural differences in fans' …

Performance Of Number Of Factors Procedures In Higher Order Analysis: A Comparative Study, Marc Thomas Porritt

Loma Linda University Electronic Theses, Dissertations & Projects

Exploratory Factor Analysis (EFA) is one of the primary statistical tools available for the verification of the structure of a psychological measure. In the case of a nested test the structure of the higher levels is verified by performing EFA on the factor scores of the lower levels, a process known as higher order factor analysis (HOFA). One of the most significant decisions made during the EFA process is how many factors to extract. A number of methods have been developed to empirically answer this question. These methods have been proven highly accurate under normal circumstances. Since HOFA is an …

Exploring Healthcare Simulation As A Platform For Interprofessional Education, Janice Christine Palaganas

Loma Linda University Electronic Theses, Dissertations & Projects

Interprofessional education (IPE) is gradually recognized as essential to patient safety and implemented as a standard for healthcare education through professional organization recommendations and accrediting bodies. Given the increasing adoption of experiential and team-based learning, healthcare simulation (HCS) has become a preferred vehicle for IPE. As healthcare professional educators explore simulation as a platform for IPE, a need to better understand the state of the science has become apparent. This descriptive comparative study examines how the most commonly used simulation modalities and IPE teaching methods (low-technology versus high-technology; multiprofessional versus collaborative team-based activities; observational versus active methods; standardized patients versus …

Modified Administration Of The Wais-Iv For Visually Impaired Examiners: A Validity Study, Amy Pitchforth

Loma Linda University Electronic Theses, Dissertations & Projects

Opportunities in all areas of life including education, vocation, and access to general information have historically been slower for minorities. The visually impaired have continued to struggle with access to education, equal opportunities at work, and access to general information. Significantly fewer blind and visually impaired individuals pursue graduate education with the most commonly pursued graduate degree being psychology (American Federation for the Blind, 2010). A core area of graduate training [defined by the American Psychological Association (APA)] is declarative knowledge, which is not accessible for the visually impaired student for neurological assessments (Johnson-Greene, Braden, Dial, Fitzpatrick, Leung, Schneider, & …

In‐Vitro Comparison Of Tensile Bond Strength Of Denture Adhesives On Denture Bases, Doris Rachel Kore

Loma Linda University Electronic Theses, Dissertations & Projects

PURPOSE: To evaluate the tensile bond strength (TBS) of three cream denture adhesives and one wafer denture adhesive on three denture base materials at five time intervals up to 24 hours. METHODS: Fixodent (Proctor & Gamble™), Super Poligrip (GlaxoSmithKline™), Effergrip (Prestige Brands, Inc.™), and SeaBond (Combe™) were tested with the Instron testing machine on three denture base resin cylinder models fabricated from two heat‐polymerized (Lucitone 199 and SR Ivocap) and one visible lightcured, shade stable (Eclipse) acrylic resins. Laboratory prepared artificial saliva with mucin was used for the control study. In accordance with ADA specifications, the TBS was tested at …

Breastfeeding Attitudes And Intentions Among Middle Eastern Women Living In Southern California, Christina Irsilious Fam

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Breastfeeding is unsurpassed as the preferred method of feeding infants all over the world due to the fact that its benefits far outweigh those of infant formula. Mothers from all cultures prefer breastfeeding, yet with immigration and emigration so widespread from developing countries, women's value systems are changing to adapt to their new surroundings. The United States has experienced a great influx of Middle Easterners; California in particular has a dominant presence of Middle Easterners. Many are faced with obstacles and stresses in acculturation, which may lead to lack of breastfeeding their infants. Few studies are available on Middle …

Differences In Iq And Memory Of Monolingual/Bilingual Children Who Suffered A Tbi, Julie Alberty

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric traumatic brain injury (TBI) occurs at an average rate of 180 per 100,000 children who are hospitalized for head injury within the United States (Schwartz et al., 2003). Bilinguals are a large proportion of the population living in the United States and in Southern California, particularly. If children who are bilingual incur a TBI, will they have even more difficulty than monolinguals with language tasks because they have a smaller vocabulary base? This study aims to further elucidate whether verbal memory will be more severely impacted than nonverbal memory in this same bilingual pediatric TBI population. 18 children (M …

Couple's Relationship With Diabetes: Transformation, Partnership, And Management, Ruth Houston Barrett

Loma Linda University Electronic Theses, Dissertations & Projects

This study used an MFT perspective to examine a model of three bio-psychosocial constructs, seeking to depict key dimensions of what makes couples successful in managing the demanding self-care regimen of diabetes. The model includes a meaning and emotion-oriented construct called relationship with diabetes, a psychosocial relational construct of diabetes-specific partnering support, and their direct and indirect effects on an endogenous construct of success in diabetes management. Surveys from 118 adult couples with diabetes provided data to test the hypothesized path and measurement model. Correlational and multiple regression analysis examined variable relationships, factor analysis examined construct dimensionality, and structural equation …

Qualitative Study Of Psychosocial Needs For Individuals With Lung Cancer, Kevin R. Criswell

Loma Linda University Electronic Theses, Dissertations & Projects

Lung cancer affects many people in the United States, accounting for 14.5% of cancer cases in 2010. Additionally, it is responsible for more cancer-related deaths than any other cancer type. Those living with lung cancer also experience a higher prevalence of psychological distress and mood problems relative to most other cancer types. Despite the high physical and mental health burden borne by those living with lung cancer, psychosocial research on lung cancer generally lags far behind comparable studies in other cancer populations. Evidence from the few interventions developed specifically for lung cancer patients demonstrate an underutilization of those services, which …

Influence Of Outdoor Air Quality On Maxillofacial Growth And Development, Ryan Rudd

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Mild to moderate deviations from normal facial types can significantly change orthodontic treatment modalities. Studies linking ambient air pollution with respiratory problems, as well as craniofacial morphology with respiratory problems are well established.1-19 In this study we aimed to determine if there was a correlation between ambient air pollution and maxillofacial growth and development. We also wanted to determine if further research should be done in this area, and if so how can the study be improved. Materials and Methods: We selected Santa Maria, CA and Upland, CA as sample areas due to their significant differences in air quality. …

Reliability And Validity Of The Outcome Questionnaire In A Heterogeneous Cancer Population, Laura Testerman

Loma Linda University Electronic Theses, Dissertations & Projects

The Institute of Medicine (IOM) and National Cancer Comprehensive Network (NCCN) now require integration of psychosocial care into the treatment of cancer patients to identify, monitor, and treat psychosocial distress. Despite the widespread use of Patient Reported Outcomes (PRO) for these purposes, no gold standard PRO for assessing distress exists for psycho-oncology research and clinical practice. This study examined the reliability, validity, and preliminary treatment effects of the Outcome Questionnaire, a PRO never before been used or validated with heterogeneous cancer patients. Adult cancer survivors were recruited nationwide to participate in an online support group (N=187) and randomly assigned to …

Effect Of Time On Gypsum-Impression Material Compatibility, John Boram Won

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the compatibility of dental gypsum with three recently introduced irreversible hydrocolloid (alginate) alternatives. The test materials were Alginot® (Kerr™), Position Penta Quick® (3M ESPE™) and Silgimix® (Sultan Dental™). The irreversible hydrocolloid impression material, Jeltrate Plus antimicrobial® (Dentsply Caulk™) served as the control. Materials and Methods: Testing of materials was conducted in accordance with ANSI/ADA Specification No. 18 for Alginate Impression Materials. Statistical Analysis: The 3-Way ANOVA test was used to analyze measurements between different time points at a significance level of (p < 0.05) Outcome: It was found that there was greater compatibility between gypsum and the alternative materials over time than the traditional irreversible hydrocolloid material that was tested. A statistically significant amount of surface change/incompatibility was found over time with the combination of the dental gypsum products and the control impression material (Jeltrate Plus antimicrobial®).

Relationship Between Nut Consumption And Memory Domains Of Cognitive Function Among Elderly Seventh-Day Adventists, Angeline B. David

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. To determine the relationship between consumption of all types of nuts, tree nuts, and peanut and peanut butter and specific memory domains of cognitive function in a community-dwelling elderly population.

Design. Cross-sectional analysis using clinic data from the Biopsychosocial Religion and Health Study and dietary intake data from the Adventist Health Study-2.

Subjects/Methods. Adults aged 50 and older were administered the California Verbal Learning Test-II (CVLT) Short Form and provided self-report frequency and portion sizes of nut consumption, anthropometric measures, and other demographic, lifestyle, and clinic data. CVLT scores were age- and gender-strata specific z-scores normed to a …

Training Manual For Providers Of Psychoeducational Services To Fms Patients, George E. Vasquez Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

Fibromyalgia syndrome (FMS) is a chronic pain syndrome that is typically characterized by chronic and widespread pain; tenderness; sleep problems, fatigue, and muscle stiffness. Additional symptoms are many and can include cognitive impairment, numbness, and psychological distress such as anxiety and depression. FMS is typically diagnosed using criteria that were established by the American College of Rheumatology in 2010 and is currently experienced by approximately 5 million adults in the United States. A biopsychosocial conceptualization of the etiology of FMS currently exists, wherein the development of FMS is attributed to the interplay of particular predisposing, precipitating, and perpetuating factors. The …

Effects Of Consuming Beans Before Or With A Meal On Satiety And Gastrointestinal Hormones Concentration In Obese Men And Women, Lisa Delia Griffith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Consuming beans and staggering meals may control energy intake. We examined the effect of consuming 0.5 cup of beans 15 minutes before a meal on gastrointestinal (GI) peptides concentrations in obese men and women.

Methods: A randomized crossover design was used to measure GI peptides response to two test meals in 28 healthy obese adults. Subjects consumed a standardized breakfast meal on each test day followed by one of two test meals: a meal incorporating 0.5 cup of beans (control bean meal), and an isocaloric meal (staggered bean meal) in which 0.5 cup of beans was consumed 15 minutes …

Accuracy Of Ortho Insight 3d Digital Scanner In Mesial-Distal Tooth Measurements, Andrew A. Ferris

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Digital scanners and software may be used to measure mesial-distal (MD) tooth width for orthodontic diagnosis and treatment planning. Although there have been many studies performed on different digital scanners, accuracy of mesial-distal tooth measurements using the Ortho Insight 3D scanner and its software (Motionview Software LLC) has not been reported. Purpose: The objective of this study was to determine if the MD tooth measurements from the digital models scanned by Ortho Insight 3D are accurate compared to the measurements taken directly from the teeth and models with a digital caliper. Material and Methods: Individual MD tooth measurements were …

Dental And Buccal Bone Stability After Rapid Maxillary Expansion And Fixed Orthodontic Treatment, Allison Milliner

Loma Linda University Electronic Theses, Dissertations & Projects

The objective of this study was to quantitatively evaluate, via CBCT, the dental and osseous effects of patients who had completed comprehensive orthodontic treatment with rapid maxillary expansion (RME) in conjunction with Ricketts prescription brackets. Thirty consecutive patients (16 males, 14 females; mean age = 13.9  1.9 years) who required RME as part of their orthodontic treatment and had pre-RME (T1), post-RME (T2) and final orthodontic (T3) CBCT images were included in the study. Thirteen patients had 2-banded, while 17 had 4-banded appliances. Measurements of interdental distance (ID), interdental angle (IA), buccal bone thickness (BBT) and buccal marginal bone …

Dual Physician Couples: An Exploration Of Family Stressors And Coping, A. Benjamin Zinke

Loma Linda University Electronic Theses, Dissertations & Projects

Physician families have experienced significant changes in the last half century as the rise of female physicians has resulted in an increase in the number of dual physician couples. The present research is a qualitative study of dual physician couples (N = 32). A social exchange framework is used to conceptualize the costs and rewards that dual physician couples experience with regards to work and family domains. A constructivist grounded theory was used as a theory of methodology so that findings were grounded in the data. Results of this study showed that couples tended to struggle for what was important …

Social Marketing Approach To Recruit Cancer Survivors For Research And Treatment, Narineh Hartoonian

Loma Linda University Electronic Theses, Dissertations & Projects

Recruitment is fundamental to project success and the production of clinically and statistically meaningful results. However, researchers have been challenged to recruit adequate numbers of participants for supportive interventions for cancer survivors (Buss et al., 2008). The purpose of this dissertation was to use social marketing theory as a framework to better understand recruitment for a web-based psychosocial intervention for cancer survivors. The study sample included cancer survivors from the Loma Linda University cancer registry or reached via population-level recruitment efforts (e.g., web and print advertisements). Of the 384 eligible potential participants, 197 fully enrolled in the intervention. Among potential …

Effectiveness Of Resin Infiltration And Mi Paste Cpp-Acp In Masking White Spot Lesions, Melissa Wu Bailey

Loma Linda University Electronic Theses, Dissertations & Projects

The development of decalcification around orthodontic brackets and bands, commonly called white spot lesions (WSLs), is often observed in patients with poor oral hygiene during treatment (Behnan et al., 2010, Rodgers et al., 2010). In many instances, these WSLs continue to be visible after the removal of fixed appliances and after natural remineralization. The purpose of this in vitro study was to compare the effectiveness of two treatment modalities, resin infiltration (RI) and Casein Phosphopeptide Amorphous Calcium Phosphate (CPP-ACP), at improving the light reflectivity and thus the appearance of WSLs using spectrophotometric analysis. Sixty extracted human third molars were partially …

Evaluation Of Apical, Coronal And Occlusal Form Diffrences With Conventional Orthodontic Treatment, Tamar Sardarian

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Cone-beam computed tomography (CBCT) can be used to accurately identify dental landmarks in order to detect changes in dental arch forms. Purpose: The objective of this study was to determine how apical, coronal and occlusal arch forms change following orthodontic treatment with fixed appliances and to establish a base for future studies. Material and Methods: Maxillary and mandibular apical, coronal and occlusal landmarks of 27 subjects were selected on their respective CBCT images at two time points: pre-orthodontic treatment (T1) and post-orthodontic treatment (T2). Comparisons were made between the two time points to evaluate how each arch form changed …

Modernization Of Care: Self-Determination And Homeless Policy In San Diego, Patricia Mary Leslie

Loma Linda University Electronic Theses, Dissertations & Projects

Many disciplines are interested in the impact of modernization on various aspects of society. Modernization contributes to greater complexity, rationalization, and individualization in social structures and human interactions. Has modernization also impacted the professional response to social problems? This study explores whether modern evidence-based practice homeless policy aligns with the core principle of selfdetermination identified in the Code of Ethics adopted by the National Association of Social Workers (NASW). Homeless policy for the San Diego region and surveys completed by 367 homeless persons during the Sharing the San Diego Story (SSDS) project are used to explore whether or not local …

Mechanical Evaluation Of Mandibular Defects Restored With Rhbmp-2: A Finite Element Model, Jelson Yalung

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: The utilization of recombinant human Bone Morphogenetic Protein-2 (rh- BMP2) to form new bone has been shown to be a promising alternative to autogenous bone grafts. Understanding the biomechanical properties of rhBMP-2 restored mandibular defects would provide useful knowledge in the future success of orthopedic and dental treatment in patients who have had restoration of mandibular defects with rhBMP-2. The aim of the study was to evaluate and compare the biomechanical characteristics of rhBMP-2 regenerated bone in mandibular defects using 2 different concentrations of rhBMP-2 with a given carrier in non-human primates Material and Methods: Critical-sized defects (approximately 2.5 …

The Ratio Of Positive To Negative Affect, Flourishing, And Health Behavior, Michael Stuart Leibow

Loma Linda University Electronic Theses, Dissertations & Projects

The ratio between positive and negative affect, known as the positivity ratio (PR) is thought to be associated with flourishing (psychological and social well-being). However, little research has been done on how PR and flourishing relate to specific health behaviors. The relationships between PR and flourishing with health behavior i.e., physical activity, and diet (fruit, leafy green vegetables [LGV] and meat intake) were investigated in this study. We examined whether PR mediated the relationship between flourishing and health behaviors, and whether flourishing mediated the relationship between PR and these behaviors. Gender and ethnic differences for the above associations were examined …

Brief Heterogeneous Inpatient Groups: A Process-Oriented Psychoeducational Model, Wesley Cook

Loma Linda University Electronic Theses, Dissertations & Projects

In the U.S., we currently have an increase in admissions to psychiatric hospitals and a lack of research exploring inpatient group psychotherapy. Diagnostically homogeneous therapy groups outperform therapy groups with mixed symptoms, however, due to managed health care, psychiatric hospitals typically run brief duration, diagnostically heterogeneous groups. A review of the research literature was conducted in order to locate empirical studies that could offer treatment recommendations regarding how to facilitate brief duration, diagnostically heterogeneous inpatient psychotherapy groups. Although this review revealed little information about this specific type of group, common factors from inpatient studies were extracted. Based on a synthesis …

Evaluating The Effectiveness Of The Yasp Intervention: Adolescent Substance Use Outcomes, Whitney Nicole Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Issues of alcohol and drug use are more pronounced during adolescence than at any other period of the life span. There is currently a need for research focusing on evaluating developmentally appropriate interventions for adolescents at risk for substance use issues. The present study seeks to evaluate the effectiveness of YASP (Youth Alternative Solutions Program), a hospital-based intervention program at Loma Linda University Medical Center. It is hypothesized that participation in YASP will decrease levels of substance use, change substance use outcome expectancies, decrease negative consequences resulting from substance use and increase participants sense of self-efficacy. A sample 27 adolescents …