Vital and Health Statistics Commons^™

Benefits And Barriers To Hiv Testing In A Population Of Federal Detention Inmates, Nicole A. Knight

Loma Linda University Electronic Theses, Dissertations & Projects

Voluntary HIV testing in combination with early medical intervention has been shown to be effective in reducing the rate of new infections and improving the health and life expectancy of those living with HIV. There are however several high-risk populations in the US that remain largely unreached by HIV testing efforts, some of which could be reached while they spend time in prison or jail. Per current Bureau of Prisons (BOP) policy, HIV testing is routinely offered only to “high risk” pretrial and sentenced inmates. We conducted a cross-sectional study with 721 pretrial and sentenced inmates who entered a large …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

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, …

The Application Of Dialectical Behavior Therapy To Chronic Pain Management, Jacob S. Iwaszewski

Loma Linda University Electronic Theses, Dissertations & Projects

Pain affects more than 50 million Americans annually, costs over 150 billion dollars each year in healthcare and legal expenses, and results in decreased work productivity and missed work days (Ballantyne, 2006; Boll, Raczynski, & Leviton, 2004; Thom, 2004). It is estimated that chronic pain negatively impacts 15% to 33% of the US population (Bokarius et al., 2008). Third-wave acceptance-based therapies, such as Dialectical Behavior Therapy (DBT), have demonstrated significant improvements in mental health functioning for a variety of populations (Carmody & Baer, 2008; Cusens, Duggan, Thome, & Burch, 2010). DBT, one of the primary treatment modalities for Borderline Personality …

Factors That Inhibit Or Enhance Maternal Coping With Stillbirth In Chhattisgarh, India, Lisa R. Roberts

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Over half of the known stillbirths occur in four highly populated countries—India among them. While acknowledged as a significant public health issue in western societies, little is known about maternal coping with stillbirth in developing countries. The purpose of this mixed methods study is to explore how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India.

Methods: In Phase 1 of this mixed methods study, grounded theory methods were used to explore perceptions regarding stillbirth. A de-identified medical records review of 536 deliveries at Christian …

Impact Of Ambient Air Pollution On Survival Of Renal Transplant Recipients, Rhonda Kristine Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

There is increasing evidence that ambient air pollution is associated with coronary heart disease morbidity and mortality. This research has focused on the general public and less so on possible sensitive subgroups even though these may have even greater susceptibility to adverse effects of ambient air pollution. With highly prevalent traditional as well as nontraditional risk factors, renal transplant recipients may potentially be a sensitive subgroup. The purpose of this study was to evaluate the possible effect of between long-term exposure to air pollution on the risk of CHD mortality among renal transplant recipients. This cohort study includes 32,239 adult, …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

Low Birth Weight, Very Low Birth Weight And Infant Mortality In San Bernardino County : A Secondary Analysis Of Maternal Factors, Rebecca D. Nanyonjo

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: National and state infant mortality rates have slowly declined over the last several years. Despite this reduction, San Bernardino County still has one of the highest infant mortality rates in California and racial disparities between Black and White infants not only persist but continue to widen. These disparities remain at the forefront of concern. Healthy People 2010 target objectives have yet to be reached, while national and state proposed plans have supported the statement that a community's largest health problem is initiated by its infant mortality. The purpose of this study was to investigate maternal factors through use of …

The Outcome Of Mta As A Root End Filling Material: A Long Term Evaluation, Christopher M. Sechrist

Loma Linda University Electronic Theses, Dissertations & Projects

Periradicular surgery is a viable option to save natural teeth when non-surgical treatment fails or when endodontic retreatment is not feasible or contraindicated. Laboratory and animal studies have demonstrated that MTA is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to provide long term (>3 years) clinical evidence for its use as a root-end filling material in endodontics. The clinical records of 294 patients who had MTA used during endodontic treatment from 1996 to 2001 were reviewed. From these, 75 patients whose root end cavities had been filled …

Prevalence Of Various Upper Extremity Disorders In Patients With Carpal Tunnel Syndrome Versus Patients Without Carpal Tunnel Syndrome, Daniel C. Buda

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose: Increasingly larger numbers of patients present with repetitive strain injuries of the upper extremities, especially carpal tunnel syndrome (CTS). A large number of these patients appear to have more than one upper extremity condition. The purpose of this study was to determine the probability that a patient diagnosed with carpal tunnel syndrome will also be diagnosed with other upper extremity and/or cervical spine disorders.

Subjects: A group of 188 subjects diagnosed with carpal tunnel syndrome and a group of 203 subjects without carpal tunnel syndrome were selected through a chart review of patients at Loma Linda …

The Role Of Diet And Physical Activity For Ovarian Cancer Results From The Adventist Health Study, Fatemeh Kiani

Loma Linda University Electronic Theses, Dissertations & Projects

A few aspects of the epidemiology of ovarian cancer are well understood, such as the inverse relationship with parity and oral contraceptive (OC) use. The role of other factors such as the potential influence of diet or physical activity is far from being established. A few studies, however, have been able to identify dietary risk factors for ovarian cancer. In this dissertation, I have conducted two studies that investigate the relationship between dietary factors and physical activity and the three endpoints: 1) nonfatal ovarian cancer (1976-1982; time to diagnosis), 2) fatal ovarian cancer (1976-1988; time to death), and 3) total …

Risk Factors Associated With Infant Mortality Among Very Low Birthweight Infants Of Teenage Mothers In San Bernardino County, C. Letitia Henry

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Typically, infant mortality decreases as maternal age increases in teenagers. In contrast to these national data, San Bernardino County (SBC) experienced a different phenomenon in 1989-1994 among very low birthweight (VLBW) infants. The infant mortality rate (IMR) of VLBW infants born to mothers under 17 years old (283 per 1000 live births) was significantly lower than the IMR of VLBW infants born to mothers between the ages of 17-19 years old (430 per 1000 live births) (p = .02).

Purpose. The purpose of the study was to explain the discrepancy between IMRs of VLBW infants of younger teenage mothers …

Body Weight And Mortality Among Adults Who Never Smoked, Pramil N. Singh

Loma Linda University Electronic Theses, Dissertations & Projects

Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m²) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m²), an association that, if causal among healthy adults, is without adequate pathophysiologic support.

In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

Association Between Nutrient Intake And Risk Of Coronary Heart Disease In California Seventh-Day Adventists, Peter Pribiš

Loma Linda University Electronic Theses, Dissertations & Projects

Dietary habits are believed to be major determinants of risk of coronary heart disease (CHD). Studies of high and low risk populations have suggested several nutrients to be protective or hazardous against CHD. Most published work since 1984 on diet and CHD in the Adventist Health Study (AHS) population examined either foods or food groups. This study investigated ten nutrients as exposure variables and their relationship to CHD risk. A cohort of 23,616 nonsmoking, non-Hispanic white California Seventh-day Adventists was followed for six years beginning in 1976. Extensive dietary information was collected at baseline, as well as values of traditional …

The Impact Of A Primary Health Care Training Program On Morbidity In Kiyeyi, Rural Uganda, 1986-1991 : An Evaluation Of The Uganda-Finland Health Care Program, Marja-Leena Salin

Loma Linda University Electronic Theses, Dissertations & Projects

This study examines the effects of primary health care education efforts in reducing the disease case rates of acute respiratory infections, diarrhoea, malnutrition and measles in a rural Ugandan population between 1986 and 1991.

The intervention, a health education program offered by the Kiyeyi Health Center staff, consisted of a 12-week intensive training for community health workers and traditional birth attendants. Follow-up and supervision took place at regular intervals and continuing education was arranged every other year. Beginning in 1986, this training program was introduced in the first of seven clusters of villages, then expanded successively on an annual basis …

Diet And Colon Cancer Risk In The Population Of Thailand, Nithat Sirichotiratana

Loma Linda University Electronic Theses, Dissertations & Projects

Epidemiological studies have emphasized environmental influences, especially a diet high in animal fat and low in fiber, as major risk factors for colon cancer. In order to examine the relationship between dietary fat and fiber and occurrence of colon cancer, patient medical records from the National Cancer Institute between 1981-1991 were used for the first hospital-based case-control study of diet and colon cancer in Thailand. These records included a total of 168 cases and 357 controls. Data on the frequency consumption of various food items were obtained by using an existing food frequency questionnaire, completed as part of patient’s history …

Misfit Between Motivational Style And Type Of Job Demand As A Factor In Developing Occupational Stress, Arlene Gray Blix

Loma Linda University Electronic Theses, Dissertations & Projects

Occupational stress is costly in terms of human suffering and impaired organizational effectiveness. Occupational stress involves the interface between the individual worker and the work environment. The purpose of the study was to analyze the fit between motivational style and the type of job demands as a contributing factor in developing occupational stress symptoms. A literature review of occupational stress models was conducted. The six models compared and contrasted included the Person-Environment fit model (French, Rodgers, & Cobb, 1974), Integrative Transactional Model (Schuler, 1982), Organizational Stress Models (Ivancevich & Matteson, 1987; Parker & DeCotiis, 1983), Facet Analysis Model (Beehr & …

Correlates Of Birth Weight And Gestation Age : Baseline Data For Health Education, Adanetch Kidanemariam

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose. The study examined the correlation of maternal occupation, urinary tract infection, smoking, and working during pregnancy with infant birth weight and gestational age in order to generate baseline data for development of a health education intervention program protocol for pregnant women In the work place.

Primary Hypotheses. (1) The four maternal risk factors: (a) occupation during lifetime, (b) reported urinary tract infection, (c) cigarette smoking, (d) working, are individually and interactively correlated with infant birth weight and gestational age. (2) The effects of the interactive associations are greater on birth weight than gestational age.

Procedure. A sample of …

The Effect Of Dietary Alpha - Linolenic Acid On Apparent Risk Factors Of Cardiovascular Disease, Kelvin D. Lindbeck

Loma Linda University Electronic Theses, Dissertations & Projects

Eight healthy male lacto-ovo-vegetarian subjects averaging 28.0 ± 3.6 years of age (22 to 53 years) were fed a diet rich in α-linolenic acid (18:3 ω 3) for four weeks. Arterial blood pressure and body weight were recorded each week. Plasma 6-keto-prostaglandin F_1α (6-keto- PGF_1α ), thromboxane B₂ (TXB₂), total cholesterol, triglyceride, and total phospholipid fatty acid composition were analyzed at 0, 2 and 4 weeks.

Systolic blood pressure increased significantly between weeks 0 and 1 (106.5 ± 2.7 mmHg to 114.0 ± 3.7 mmHg; p < 0.003), but decreased to 107.3 t 2.6 mrHg (p < 0.02) at week 2. There was an insignificant increase in both systolic and diastolic blood pressures after four weeks. There was no significant change in either total cholesterol or triglyceride levels during the four weeks.

Plasma 6-keto-PGF_1α levels increased significantly from 60.13 ± …

Models For Estimating Psychiatric Bed Needs, Patricia A. Brenneman

Loma Linda University Electronic Theses, Dissertations & Projects

Inland Counties Comprehensive Health Planning Council wished to estimate the psychiatric bed needs by type (such as state hospitals, board and care homes, etc.) in San Bernardino County from the distributions of patient arrivals and of lengths of stay. A statistical description of the system during 1973 was considered the first step toward estimating future bed needs. A computer simulation model using IBM's programming language General Purpose Simulation System (GPSS) was developed and was found to be unsatisfactory.

Theorems were then developed for a statistical model, seeking to predict future bed needs. The most convenient of these theorems states that …

Selected Factors Related To Ability To Regain Bladder Function Following Indwelling Catheterization, Jongkolnee Padmasiri

Loma Linda University Electronic Theses, Dissertations & Projects

This exploratory retrospective study was designed to evaluate selected factors, including the ability to regain bladder function related to post indwelling urethral catheterization in an acute general hospital population.

The records of 107 patients who met the study criteria became the study population. These patients had three-way urethral catheters, continuous antibacterial irrigation and closed drainage system. Twenty patients died (19 percent) before the catheter was removed. Of the 87 patients who were alive, 37 percent (32 patients) had in-adequate bladder function. Of these 32 patients, no attempt was made to remove the catheter from 15 prior to their hospital discharge. …

Sero-Epidemiology Of Q Fever With Special Reference To Complications In A Hospital Population Of Southern California, Ajit Singh Randhawa

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

The Effects Of Particular Sounds On Certain Indices Of Cardio-Pulmonary Functions, Harold F. Googe, Jane Mundin

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the effects of particular sounds upon certain indices of cardio-pulmonary function and the degree and pattern of changes which occurred in the indices. The specific physiological parameters chosen to be monitored were heart rate, respiratory rate, mean tidal volume, instantaneous minute volume, and oxygen consumption. The hypothesis was that particular sounds will cause changes in certain indices of cardio-pulmonary functions. This was a controlled experiment, in which nine healthy males and nine healthy females, of a denominational, medically oriented University listened to a specially constructed tape of background music interspersed with an …

A Study Of Fever Differences Following Cardiac Surgery, Cleta Phyllis Lane

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to find out whether the temperature level following heart and great vessel surgery is greater following the use of the heart-lung machine than those following closed heart surgery or cardiac and great vessel surgery with the use of hypothermia.

The method used was the descriptive survey. Data were obtained from medical records in one selected hospital. The desired number of charts was 50 for each of the three categories. The categories were identified by groups as follows:

Group I: patients having had cardiac surgery by a closed heart technique. All of the patients in …