Digital Commons Network^™

Reduced Bayesian Hierarchical Models: Estimating Health Effects Of Simultaneous Exposure To Multiple Pollutants, Jennifer F. Bobb, Francesca Dominici, Roger D. Peng

Johns Hopkins University, Dept. of Biostatistics Working Papers

Quantifying the health effects associated with simultaneous exposure to many air pollutants is now a research priority of the US EPA. Bayesian hierarchical models (BHM) have been extensively used in multisite time series studies of air pollution and health to estimate health effects of a single pollutant adjusted for potential confounding of other pollutants and other time-varying factors. However, when the scientific goal is to estimate the impacts of many pollutants jointly, a straightforward application of BHM is challenged by the need to specify a random-effect distribution on a high-dimensional vector of nuisance parameters, which often do not have an …

The Non-Infectious Disease Implications Of Bed Bug Infestations, Christopher T. Balster

Master of Public Health Program Student Publications

The purpose of this study was to determine the prevalence of bed bug infestations throughout Ohio, whether the non-infectious disease implications of infestations are public health concerns, and also determine the perceived ability of public health departments to respond to outbreaks within their jurisdiction. A descriptive study was performed using survey data obtained from 79 local public health departments throughout Ohio. Overall, 79.05% of individuals surveyed agreed that bed bug outbreaks are a public health concern. The mode of responses regarding whether or not the non-infectious disease concerns of infestations are a public health concern was 4 on a scale …

Cultural Conceptions Of Health, Caroline Stephens

Independent Study Project (ISP) Collection

Healthcare is a complicated structure, influenced by multiple economic, social and cultural factors. It is problematic enough to determine how to administer healthcare in countries that rely only on the western healthcare system, but it is even more difficult in places such as Madagascar where multiple healthcare systems exist. Today the Malagasy have a culture that combines the many French practices with the traditional Malagasy beliefs, traditions and values. Many Malagasy chose to utilize allopathic medicine, but many others still prefer to go to a traditional healer. By gaining a better understanding of the average Malagasy person’s perceptions of proper …

The Benefits Of Having An Integrated Health Care System In Madagascar, Elizabeth Miller

Independent Study Project (ISP) Collection

For my individual research, I wanted to look into all the benefits that could be offered by collaborating allopathic and traditional healthcare systems and how such a system is accomplished in Madagascar, in order to weigh and to discover the feasibility of using integrated healthcare systems as sustainable development in other parts of the world. Furthermore, as Madagascar sets the example in my research this summer, the use of traditional and modern medicine as an integrated health care system best serves the majority of the Malagasy population for several important reasons.

Influenza Vaccination Of The Healthcare Workforce: Developing A Model State Law, Alexandra M. Stewart, Marisa A Cox

Health Policy and Management Faculty Publications

No abstract provided.

Medical Pluralism In Morocco: The Cultural, Religious, Historical And Political-Economic Determinants Of Health And Choice., Tyler Martinson

Independent Study Project (ISP) Collection

Morocco is a culturally diverse intersection between the African continent, the Arab world and Europe. This multiplicity is mirrored in the country’s pluralistic medical system and beliefs surrounding the concepts of illness and health. Explanations of health are endorsed by culturally specific knowledge and are then naturalized and taken as objective. A synthesis of theoretical descriptions and political-economic of medical pluralism, along with historical analysis, explains the presence of multiple health practices and how a person’s choice of medical practice is heavily influenced by dynamic socio-cultural, religious, historical, political and economic factors. This study will help improve practitioner/client narratives of …

The Referral Process: Rural Primary Care Physicians' Perspectives On Providing Counseling Referrals, Casey N. Tallent

College of Education and Human Sciences: Dissertations, Theses, and Student Research

The advantages to collaborative care between physicians and mental health care providers have been known for many decades. Rural primary care physicians (RPCPs) are the first professionals that most patients contact when they have a mental health concern, particularly in rural communities. It is therefore important to understand the process that occurs when a referral for counseling is made from a RPCP and the subsequent collaboration that occurs. The purpose of this qualitative study was to generate a model that provides a better understanding of the counseling referral process from the perspective of RPCPs in private practice in the Midwest. …

Preventing Workplace Injuries Commonly Sustained By Hotel Guestroom Attendants, Jennifer Daros

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction:

Hotels are generally organized into various departments. These provide specialized services to guests. Almost every hotel in the world has (in one form or another) a housekeeping department. Guestroom attendants (GRAs) are a primary component of any housekeeping department. GRAs (also known as maids, housekeepers, or room/suite service attendants) are employed by hotels to clean guestrooms, change bed linens, restock supplies, and provide turn down services when requested (see Appendix A). Those employed as GRAs frequently suffer injuries at work that can be costly to employers. This paper reviews some of the more common causes of GRA workplace injuries …

Using Modeling And Simulation To Improve Oral Health Services Delivery In Hampton Roads, Virginia, Mohammad J. Alzahrani

Health Services Research Dissertations

The purpose of this study is to examine the system performance in delivering oral health services in a public health district based on the Conceptual Framework to Measure Performance of the Public Health System (PHS). Using modeling and simulation, a predictive model based on the conceptual framework dimensions: mission, structural capacity, processes, and outcomes was developed to predict the performance of public health district in delivering oral health services.

This is a retrospective longitudinal study. The main objective of this study is to use a modeling and simulation approach to predict the performance of public health district dental clinic in …

Adherence To Accelerometer Protocols Among Women From Economically Disadvantaged Neighborhoods, Patricia A. Sharpe, Sarah Wilcox, Laura J. Rooney, Donna Strong, Rosie Hopkins-Campbell, Jean Butel, Barbara E. Ainsworth, Deborah Parra-Medina

Faculty Publications

Background: Objective measurement of physical activity with accelerometers is a challenging task in community-based intervention research. Challenges include distribution of and orientation to monitors, nonwear, incorrect placement, and loss of equipment. Data collection among participants from disadvantaged populations may be further hindered by factors such as transportation challenges, competing responsibilities, and cultural considerations. Methods: Research staff distributed accelerometers and provided an orientation that was tailored to the population group. General adherence strategies such as follow-up calls, daily diaries, verbal and written instructions, and incentives were accompanied by population-specific strategies such as assisting with transportation, reducing obstacles to wearing the accelerometer, …

Real-World Comparison Of Two Molecular Methods For Detection Of Respiratory Viruses, Syed Asad Ali, James E. Gern, Tina V. Hartert, Kathryn M. Edwards, Marie R. Griffin, E Kathryn Mille, Tebeb Gebretsadik, Tressa Pappas, Wai Ming Lee, John V. Williams

Department of Paediatrics and Child Health

Background: Molecular polymerase chain reaction (PCR) based assays are increasingly used to diagnose viral respiratory infections and conduct epidemiology studies. Molecular assays have generally been evaluated by comparing them to conventional direct fluorescent antibody (DFA) or viral culture techniques, with few published direct comparisons between molecular methods or between institutions. We sought to perform a real-world comparison of two molecular respiratory viral diagnostic methods between two experienced respiratory virus research laboratories.
Methods: We tested nasal and throat swab specimens obtained from 225 infants with respiratory illness for 11 common respiratory viruses using both a multiplex assay (Respiratory MultiCode-PLx Assay [RMA]) …

Failures In The Veterans Administration And New Strategies For Leadership, Jarrett Nathaniel Brunny

Florida Public Health Review

World news organizations have criticized the United States Department of Veterans Affairs for endangering patient safety through negligence. Several VA medical centers - including prominent centers operating in Florida - failed to sterilize endoscopy and colonoscopy equipment. Through improper sterilization, a pathway for infection is created resulting in potential disease exposures to patients. In response, the Department of Veterans Affairs Office of Inspector General investigated the reports and found that facilities did not adhere to protocol concerning reusable medical equipment (RME) problems during the practice ofperforming endoscopies and colonoscopies. The Office ofInspector General noted that the incidents reflected flaws in …

A Leadership Solution To Workplace Stress, Monica L. Rousseau

Florida Public Health Review

Sources of stress can be found nearly everywhere: in school, at home, in traffic, and maybe most importantly –in the workplace. Chronic workplace stress, also known as “burnout”, has been linked with both psychological and physiological illnesses. As most Americans spend about halfoftheir waking hours at work, the workplace is an excellent location to evaluate specific risk factors and implement stress reducing programs. Although a number ofsuch programs are currently in practice, the majority ofthem only offer techniques and coping mechanisms to individuals already exhibiting some, or several, ofthe many severe symptoms ofchronic stress. The purpose ofthis paper is to …

Perflurorochemical (Pfc) Exposure In Children: Associations With Impaired Response Inhibition, Brooks B. Gump, Qian Wu, Amy K. Dumas, Kurunthachalam Kannan

Falk College Research Center

Background: Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals.Objectives: We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Methods: Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), …

Patterns Of Fetal Heart Rate Response At ∼30 Weeks Gestation Predict Size At Birth, C. Sandman, C. J. Cordova, E. P. Davis, Laura M. Glynn, C. Buss

Psychology Faculty Articles and Research

There is evidence that fetal exposure to maternal stress is associated with adverse birth outcomes. Less is known about the association between fetal responses to a stressor and indicators of fetal maturity and developmental outcomes. The purpose of the present study was to determine whether fetal heart rate (FHR) patterns in response to a startling stimulus at ∼30 weeks of gestation were associated with gestational age at birth and birth weight. FHR was measured in 156 maternal–fetal dyads following a vibroacoustic stimulus. All pregnancies were singleton intrauterine pregnancies in English-speaking women who were primarily married, middle class, White and at …

Research On Healthcare Worker Personal Protective Equipment: Minimum Requirements For Isolation Gowns, F.Selcen Kilinc-Balci, Phd

Building the Chain of Safety: Stakeholders Summit

F. Selcen Kilinc-Balci, PhD, is a Senior Service Fellow at the National Personal Protective Technology Laboratory (NPPTL) of Centers for Disease Control and Prevention (CDC)/National Institute for Occupational Safety and Health (NIOSH). She works in the area of protective clothing and ensembles, including personal protective equipment for healthcare workers, mine rescue ensembles, fire fighter turnout gear, and chemical protective garments. Prior to joining NIOSH in February 2010, she worked as a senior engineer at DuPont Protection Technologies. Her work at DuPont focused on product development, product testing and certification, and promotional claim validation in personal protective clothing. She has more …

Overcoming Barries To Compliance, Janine C. Jagger, Phd

Building the Chain of Safety: Stakeholders Summit

Janine Jagger, PhD, is an epidemiologist specializing in injury prevention and control.  Early in her career, her research and advocacy focused on brain trauma and motor vehicle safety.

Over the last 20 years, Dr. Jagger has devoted herself to reducing healthcare workplace transmission of bloodborne pathogens.  In 1988, Dr. Jagger and colleagues published a landmark study in the New England Journal of Medicine which detailed the characteristics of medical devices causing needlestick injuries, and criteria for protective needle designs.  This pioneering research provided the foundation for the development of a new generation of safer medical devices.

In 1991, Dr. Jagger …

La Charge De Travail Et La Dépense Énergétique De L’Éducateur Physique, François Trudeau, Louis Laurencelle

Rapports de recherche scientifique

La documentation scientifique ne rapporte aucune étude sur le niveau de dépense énergétique chez les éducateurs physiques, non plus que sur les différences probables de charge entre les enseignants des différents niveaux et entre les hommes et les femmes. Les auteurs de cette étude voulaient quantifier la dépense énergétique de la tâche de l’éducateur physique dans son milieu de travail, en fonction de sa condition physique déterminée par des tests de laboratoire, mais aussi selon différents critères dont les tâches pédagogiques réalisées.

Il en résulte que la dépense énergétique moyenne des éducateurs physiques varie de faible à modéré, mais comprend …

Comparison Of Workplace Protection Factors For Different Biological Contaminants, Kyungmin Jacob Cho, Tiina Reponen, Roy Mckay, Alok Dwivedi, Atin Adhikari, Umesh Singh, Rakesh Shukla, M. Susan Jones, Gordon Jones, Sergey A. Grinshpun

Nursing Faculty Publications

This study compared workplace protection factors (WPFs) for five different contaminants (endotoxin, fungal spores, (1→3)-β-D-glucan, total particle mass, and total particle number) provided by an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR). We previously reported size-selective WPFs for total particle numbers for the ER and FFR, whereas the current article is focused on WPFs for bioaerosols and total particle mass. Farm workers (n = 25) wore the ER and FFR while performing activities at eight locations representing horse farms, pig barns, and grain handling facilities. For the determination of WPFs, particles were collected on filters simultaneously …

Weaning Onto Solid Foods In Ireland: Some Of The Challenges, A. E. Bennett, A. O'Connor, N. J. Canning, E. M. Keaveney, Katherine Younger, M. Flynn

Conference Papers

No abstract provided.

Commencement Program 2011, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2011 Events of Commencement

4 | The Academic Procession

6 | Significance of Academic Regalia

8 | The Good Samaritan

9 | University History Highlights

11 | Loma Linda University Song - "Healing Love"

12 | The Speakers

20 | The University Honorees

32 | The School Honorees

53 | The Programs

• School of Medicine, 54
• School of Pharmacy, 74
• School of Dentistry, 80
• School of Science and Technology and School of Religion, 96
• School of Nursing, 111
• School of Allied Health Professions - Physical Therapy, 121
• School of Allied Health …

Perceived Barriers And Benefits Of Hiv Voluntary Counseling And Testing Among University Students In Nigeria, Clara Egbealele Omogbai

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Nigeria, the most populous country in Africa is one of the sub- Saharan nations most affected by HIV and AIDS. However, due to stigma most people at risk of infection refuse testing, thereby likely increasing the transmission of HIV. Voluntary counseling and testing (VCT) has been shown to influence behavior change and it is important to explore how to increase rates of VCT in young people who may experiment with sexual activity in this environment that holds increased risks due to nationally elevated rates of HIV.

Purpose. To examine intention to use HIV voluntary counseling and testing (VCT) services …

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 …

Screening & Assessment Manual, Institute For Public Health And Justice, Screening And Assessment, John Ryals Jr.

Policy & Position Papers

No abstract provided.

Control Of Reflexive Saccades Following Hemispherectomy, Patricia A. Reuter-Lorenz, Troy M. Herter, Daniel Guitton

Faculty Publications

Individuals who have undergone hemispherectomy for treatment of intractable epilepsy offer a rare and valuable opportunity to examine the ability of a single cortical hemisphere to control oculomotor performance. We used peripheral auditory events to trigger saccades, thereby circumventing dense postsurgical hemianopia. In an antisaccade task, patients generated numerous unintended short-latency saccades toward contralesional auditory events, indicating pronounced limitations in the ability of a single hemicortex to exert normal inhibitory control over ipsilateral (i.e., contralesional) reflexive saccade generation. Despite reflexive errors, patients retained an ability to generate correct antisaccades in both directions. The prosaccade task revealed numerous contralesional express saccades, …

Biomechanical Analysis Of Asymmetric And Dynamic Lifting Task, Xiaopeng Jiang

Theses

Lifting tasks is one of the leading causes of occupational lower back disorders (LBD). Aimed at deriving internal forces of human musculoskeletal system during lifting, biomechanical models are utilized to address this problem. This thesis provides an indepth literature review of such modeling, and the results of experiments used to address LBD issues.

An isometric pulling experiment was conducted to study the correlation between electromyography (EMG) and predicted muscle forces by AnyBody Modeling System™ with increasing hand loads. An infinite order polynomial (min/max) optimization criterion predicted percentage of maximum muscle forces, which achieved 98% correlation with normalized EMG. In a …

Statistical Image Reconstruction For Quantitative Computed Tomography, Joshua Evans

Theses and Dissertations

Statistical iterative reconstruction (SIR) algorithms for x-ray computed tomography (CT) have the potential to reconstruct images with less noise and systematic error than the conventional filtered backprojection (FBP) algorithm. More accurate reconstruction algorithms are important for reducing imaging dose and for a wide range of quantitative CT applications. The work presented herein investigates some potential advantages of one such statistically motivated algorithm called Alternating Minimization (AM). A simulation study is used to compare the tradeoff between noise and resolution in images reconstructed with the AM and FBP algorithms. The AM algorithm is employed with an edge-preserving penalty function, which is …

Influenza And Bacterial Coinfections In The 20th Century, Xuan-Yi Wang, Paul E. Kilgore, Kyung Ah Lim, Song-Mei Wang, Jeongseok Lee, Wei Deng, Mei-Qi Mo, Batmunkh Nyambat, Jing-Chen Ma, Michael O. Favorov, John D. Clemens

Department of Pharmacy Practice

To help understand the potential impact of bacterial coinfection during pandemic influenza periods, we undertook a far-reaching review of the existing literature to gain insights into the interaction of influenza and bacterial pathogens. Reports published between 1950 and 2006 were identified from scientific citation databases using standardized search terms. Study outcomes related to coinfection were subjected to a pooled analysis. Coinfection with influenza and bacterial pathogens occurred more frequently in pandemic compared with seasonal influenza periods. The most common bacterial coinfections with influenza virus were due to S. pneumoniae, H. influenzae, Staphylococcus spp., and Streptococcus spp. …

Individualized Healthcare And Health Disparities: An Examination Of Health Disparities Related To Short-Term Response To Food Insecurity In Low-Income, Urban Communities, Valen R. Diaz

Honors Scholar Theses

The U.S. has seen a spike in chronic diseases along with worsening health outcomes. There are many factors at play to create these circumstances, especially regarding the social determinants of health, like socioeconomic status, access to food, and geographic location. Another concern is health disparities, particularly regarding obesity, and the fact that food access and neighborhood food environments contribute to these disparities. This paper gives a broad overview of American food culture and then focuses on the local food environment in urban, low-income communities, regarding both food deserts and food swamps. There is also a discussion about the response of …

Moving United States Health Care Forward, Thomas R. O'Neill

Honors Scholar Theses

Substantive Health Care reform poses one of the greatest current challenges to the American political system. The Patient Protection and Affordable Care Act of 2010 marks the most recent attempt at approaching this daunting task. Charged with expanding coverage while controlling costs, it pursues a sundry number of legislative solutions to achieve these seemingly incompatible goals. Despite the strides the Patient Protection and Affordable Care Act has made, lingering educational, pharmaceutical, and legal concerns stand to derail progress made on fixing the health care system. If these goals are to be successful, a number of additional measures are needed to …