Social and Behavioral Sciences Commons^™

Perceived Attitudes And Staff Roles Of Community Based Outpatient Clinics In Disaster Management, Pauline Antoinette Hodge-Hilton

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Natural and manmade disasters have claimed the lives of thousands of individuals in the US and caused billions of dollars in property damage. First responders carry the responsibility of disaster management, leaving other health care professionals such as medical clinic staff underutilized to support the clinic staff. We explored how medical and support staff in Community-based Outpatient VHA Clinics (CBOC) perceive their roles in disaster response, their attitudes about clinic readiness and continuity of care during disasters, and their ability to function in a post disaster environment.

Methods: A mixed method study was conducted to answer questions related to …

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 …

Perceived Parent-Child Relationship And High-Risk Behaviors Among Christian College Students, Karla G. Lavin Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Adolescents and young adults today are participating in high-risk behaviors such as dangerous sexual behaviors and drug and alcohol abuse at high rates. An increased incidence of negative effects associated with the aforementioned behaviors has led researchers to examine factors that influence and protect adolescents from certain devastating effects (Davis, Hendershot, George, Norris, & Heiman, 2007; Goldstein, Bamett, Pedlow, & Murphy, 2007; Hamilton, et al., 2007; Hingson, Heeren, & Winter, 2006; Hingson, Heeren, Winter, & Wechsler, 2003; Hingson, Heeren, Zakocs, Winter, & Wechsler, 2003; McCarty, et al., 2004; Mokdad, Marks, Stroup, & Gerberding, 2004; Mosher, Chandra, & Jones, 2005; …

Impact Of An Online Support System On Health Related Quality Of Life Among Men Diagnosed With Prostate Cancer, Daniel K. Osei

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is a major public health issue worldwide and a significant cause of male cancer death in the USA. Though early screening and treatment has greatly enhanced the outcome, men diagnosed with prostate cancer face problems that compromise quality of life after treatment. Online support for prostate cancer clients is a convenient way to help because it is anonymous, inexpensive, and can be used at clients’ convenience. Yet few studies have explored how these supports impact these clients. This study used a longitudinal randomized experimental design to examine the impact of online services on quality of life of prostate …

Relationship Of Vitamin D Levels To Blood Pressure In A Biethnic Cohort, Rosario O. Sakamoto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Serum hydroxyvitamin D [25(OH)D] has been well-accepted as not an ordinary vitamin but a pro-hormone that has many benefits beyond its well-known effects on bone. Cardiovascular risk factors such as hypertension remain a huge health burden and Blacks have been recognized to have higher prevalence of hypertension compared to non-Hispanic Whites. Despite increasing evidence of the benefits of vitamin D on blood pressure control, there is much more to be learned about the relationship of serum 25(OH)D to blood pressure among different ethnicities.

Purpose: The goal of this study was to determine whether vitamin D serum 25(OH)D levels were …

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 …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

Veterans Of The 1st Persian Gulf War: A Study Of Medically Unexplained Symptom Models, Alexis H. Collins

Loma Linda University Electronic Theses, Dissertations & Projects

In 1990-1991, shortly after the Persian Gulf War, a number of veterans began complaining about a wide range of symptoms, the most common of which were; fatigue, headache, sleep disturbance, low mood, and memory loss. These symptoms were similar to those experienced by individuals with Medically Unexplained Illnesses such as Chronic Fatigue Syndrome, Fibromyalgia, Irritable Bowel Syndrome, Multiple Chemical Sensitivity, and Somatoform Disorders. Utilizing structural equation modeling and data gathered from the Gulf War Veterans Health Questionnaire, this study attempted to determine whether symptoms experienced by veterans were best explained as individual items, discrete illnesses, or as a conglomeration of …

Psychological Profiles In A Female Bariatric Surgery Sample, Aimee L. Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Morbid obesity is an epidemic. Current literature suggests that people with morbid obesity tend to show increased levels of psychological dysfunction. This is especially pertinent to the clinicians who work with morbidly obese patients who seek bariatric surgery as the method for weight control. Surgery should be performed on patients who are psychologically ready to adjust to the stringent post-operative lifestyle.

The purpose of the present study was (1) to compare two groups of bariatric patients (a White group and a non-White group) on pre-surgery measures: specific scales on the Millon Behavioral Medicine Diagnostic (MBMD), the Beck Depression Inventory II …

Comparison Of Non-Surgical And Surgical Endodontic Retreatment: A Systematic Review, Robert Corr

Loma Linda University Electronic Theses, Dissertations & Projects

Primary root canal therapy has been shown to be a predictable procedure with a high degree of success ^1-4, however failures can occur after treatment. Treatment options for the preservation of teeth that have had previous endodontic treatment but demonstrate persistent disease include non-surgical (orthograde) or surgical (retrograde) endodontic retreatment, assuming the tooth is restorable, periodontally sound, and the patient desires to retain the tooth. The purpose of this study was to conduct a systematic review of the current available evidence to compare the clinical and radiographic outcomes of nonsurgical with those of surgical endodontic retreatment. Methodology began with …

The Use Of The Minnesota Multiphasic Personality Inventory-Ii (Mmpi-2) In Pre-Employment Evaluations, Ana M. Gamez

Loma Linda University Electronic Theses, Dissertations & Projects

Psychological testing is an important facet in the selection and hiring processes of law enforcement and public safety personnel. Research in this area suggests that the MMPI-2 scales have been correlated with problematic behavior among police officers, poor job performance, and officer misconduct. This study examined the extent to which suitability for hire could be predicted by the MMPI-2 scale L (Lie), scale K (correction), Infrequency scale (F), scale 4 Psychopathic Deviate (Pd), scale 6 Paranoia (Pa), scale 7 Psychasthenia (Pt), and scale 9 Hypomania (Ma). It examined whether profile differences emerged as a function of suitability across gender, between …

The Relationship Between The Level Of Support Group Participation And Psychosocial Factors In Prostate Cancer Patients Treated With Proton Therapy, Carol A. L. Davis

Loma Linda University Electronic Theses, Dissertations & Projects

Background. The role of support groups for cancer patients is known to be beneficial in helping people adjust to the disease, and cope with the myriad of effects that cancer has on quality of life. Although many people express interest in attending such support groups, few attend regularly. It is unclear what characteristics distinguish those who use such services from those who do not, especially among proton therapy patients.

Objective. To examine demographic and psychosocial characteristics associated with the Brotherhood of the Balloon (BOB) prostate cancer support group membership, a unique treatment-focused group originating at Loma Linda University Medical Center …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

Neurodevelopmental Outcome & Mr Spectroscopy Of Therapeutic Hypothermia After Pediatric Drowning, Sharon Mieras Perugini

Loma Linda University Electronic Theses, Dissertations & Projects

Despite advances in medical treatment and technology, outcome following pediatric drowning can vary widely from mild to severe impairments and death. Prognosis is often difficult to predict given a number of contributing factors. As such, this study examined the relationship between clinical indicators including submersion duration, initial GCS and PRISM scores, and waking time with outcome as well as metabolite ratios based on magnetic resonance spectroscopy. Research stemming from the area of cardiac arrest as well as anecdotal case study reports of cold water drownings suggests that lowering the body temperature may be helpful and protective. As such, the use …

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

Study Of The Four Factor Theory Of Women’S Sexual Function, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual function. They suggested that unique factors need to be examined to understand sexual function in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors were described as aspects of women’s lives that can be the source of sexual dysfunction. In a previous study, Merrell (2007) utilized Tiefer et al’s (2002) four factor model of sexual functioning to examine female sexual functioning looking specifically at body shame, relationship satisfaction, positive and negative affect, sexual self-schema, and overall health. Based on the results …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

The Effects Of A Psychoneuroimmunology Based Lifestyle Intervention In Modifying The Progression Of Major Depression In Clinically Depressed Adults, Ruth A. Tanyi

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic stress can lead to poorly controlled upsurges of cortisol and dysregulation of the hypothalamic pituitary-adrenal axis, thereby contributing to major depression. Hence, researchers have begun to examine the effects of individual psychoneuroimmunology (PNI) interventions and their impact on modifying stress and depression. However, there is a lack of studies that have examined the composite effect(s) of a PNI-based lifestyle intervention and major depression. Thus, this randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: combined progressive muscle relaxation and spiritual guided imagery and humor as an adjunct therapy to modifying the progression of depression. Participants were …

The Influence Of Familism On Descriptive And Injunctive Norms In Predicting The Intention To Eat A Vegetarian Diet Among Chinese Seventh-Day Adventists, See Wei Toh

Loma Linda University Electronic Theses, Dissertations & Projects

According to the theory of planned behavior (TpB), one determinant of intention to engage in a behavior is the subjective norm. Various studies have found that subjective norm is often the weaker predictor of intention compared to perceived behavioral control and attitude. This study examined whether familism (emphasis on the family rather than the individual) would contribute positively to the predictive power of the TpB model through interactions with the family portion of descriptive and injunctive norms. Descriptive and injunctive norms are component variables of the subjective norm. A sample of 284 adult Chinese Seventh-day Adventists 18 years and older …

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

Efficacy Of Cognitive Therapy And Pharmacotherapy In Depression: A Meta-Analysis, Daniel B. Michel

Loma Linda University Electronic Theses, Dissertations & Projects

A meta-analysis comparing the long-term effectiveness of cognitive behavioral therapy (CBT) and pharmacotherapy in preventing relapse following treatment discontinuation was performed using published studies of depressed participants. Twenty-three articles met inclusionary criteria and were included in the analyses. Weighted effect sizes and moderators, treatment type, were calculated using statistical analysis software. Initially, fixed effects models were applied to the data, but due to significant between-group heterogeneity that could not be fully explained by treatment type, mixed effect models were used to account for the residual heterogeneity. Results indicated that overall, depressed individuals treated to remission with CBT evidence decreased relapse …

A Study Of The Relationship Between American Evangelicals And Human Rights, Amy Rachel Timmons Stumpf

Loma Linda University Electronic Theses, Dissertations & Projects

Human rights violations and abuses affect every region of the globe. The most recent Amnesty International Annual Report details violations in 149 countries. While there are no simple solutions to a problem of this magnitude and complexity, the support of powerful social groups can help in providing relief to the victims, pressure on abusive governments, legal consequences for abusers, and other resources in combating the violence that seems to chronically plague over our world. One of the most powerful groups, with tremendous social capital, is American evangelicals. Evangelicalism, even given the loose and informal organizational structures, is one of the …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Predictors Of Female Sexual Dysfunction, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual dysfunction. They suggested that unique factors need to be examined to understand sexual dysfunction in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors described as aspects of women’s lives that can be the source of sexual dysfunction. The current study examined indicators of the above factors-body shame, relationship satisfaction, sexual self-schema, positive and negative affect, and overall health-as predictors of female sexual dysfunction. The hypotheses were: Body shame and negative affect will be negatively associated with sexual function; and relationship …

The Latino Caregiver Experience Among Dementia And Non-Dementia Caregivers : Can Community Based Care Management Improve Caregiver Health?, Catherine Oliveros

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This study provides an analysis of the Latino caregiving community in Southeast Texas and the role community based care management plays in influencing caregiver physical and emotional well-being. Design and Methods: A non-random sample of 63 Latino caregivers was interviewed by phone. Caregiver physical and emotional well-being was studied through burden, depression, perceived health status, and resourcefulness. Regression, correlation, and comparison analysis was performed with key variables. Results: Acculturation was positively correlated with care management use. In comparing dementia and non-dementia caregivers both groups had similar levels of depression and burden, however, the dementia group had significantly lower levels …

Evaluation Of Program Outcomes: Assessment In Children, Cheryl M. Romano

Loma Linda University Electronic Theses, Dissertations & Projects

In an age of increased concern for accountability and the review of services, administrators of health programs should be able to present their clinics effectiveness, and demonstrate their excellent service to the community, along with providing evidence for the continued need of such clinics. Outcome evaluation plays an integral part in providing this information, and is intended to provide information concerning the effectiveness of a particular program, thus allowing for modification, and even better outcomes.

This project addressed pre and post functioning in children referred for academic and/or behavioral difficulties, in a university of health sciences-based clinic. The aim was …

The Environmental Impact Of Dietary Choice And Agriculture In California, Harold J. Marlow Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

Food demand influences agricultural production. Modern agricultural practices have resulted in polluted soil, air and water, eroded soil, dependence on imported oil, and loss of biodiversity. The goal of this research is to investigate the environmental impact of pesticide and fertilizer application, water consumption, and energy used to produce commodities for a vegetarian and non vegetarian diet in California. The working assumption is that greater number and amount of inputs are associated with greater environmental impact. The literature supports this notion. To accomplish this goal, dietary preferences were quantified using the Adventist Health Study and state agricultural data were collected …

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 …

Autism And Parental Marital Satisfaction: The Role Of Adequacy Of Resources, Geneeta Kaliah Chambers

Loma Linda University Electronic Theses, Dissertations & Projects

The goal of the present study was to expand on the existing literature exploring families with children who have developmental disabilities, particularly autism. Previous studies have been constrained by univariate approaches that have failed to adequately capture the nuances of family functioning. Using an ecological/context approach, stemming from an ongoing research program conducted within a university-based treatment center, the present study attempted to improve on the conceptualization of interrelationships among family members and the role that contextual factors play within that dynamic. Specifically, the present study explored the influence of children’s level of autism on parents’ reports of their marital …

Psychological Factors Associated With Anticipatory Nausea And Vomiting, Melinda L. Nielsen

Loma Linda University Electronic Theses, Dissertations & Projects

Many cancer patients experience adverse chemotherapy-related side effects. The present study examined the relationships among disease variables (i.e. stage of cancer, type of breast cancer), medical treatment variables (i.e. toxicity of chemotherapy regimen, strength of antiemetic treatment), psychological variables (i.e. health locus of control, anxiety sensitivity, desire for control, coping strategies), and anticipatory nausea and vomiting in women with breast cancer. One hundred women with breast cancer completed the Multidimensional Health Locus of Control Scale - Form C, the Anxiety Sensitivity Index, the Krantz Health Opinion Survey, the Coping Inventory for Stressful Situations, and the Morrow Assessment of Nausea and …