Digital Commons Network^™

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 …

Designing An Analytic Deliberative Process For Environmental Health Policy Making In The U.S. Nuclear Weapons Complex, Seth Tuler, Thomas Webler

RISK: Health, Safety & Environment (1990-2002)

Using a National Research Council Report as a centerpiece, Drs. Tuler and Webler evaluate the effectiveness of a conceptual approach to risk policy-making.

Benchmarking Financial Operations Using The Premier Operations Outlook Database, Margaret M. Thompson

Community & Environmental Health Theses & Dissertations

Acute-care hospitals have come under increased pressure to reduce costs while increasing the quality of providing care. Historically, increasing costs of providing care has had the greatest impact on the reduction of operating margins necessary to expand capital and for repayment of debt. Facilities can benchmark internal historical data to identify areas where costs have increased and are able to explain the factors that contribute to the increases. One of the challenges facing hospitals in their efforts to reduce operating costs is how, what, and where, do they obtain comparative data to benchmark the cost of operating medical facility to …

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Gujarat, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, Pesi N. Sinor, Hemali Mehta, Fali S. Mehta

Faculty Publications

Objective: To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India. Design: A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods. Setting: Rural villages …

Centred Voices : A Study Of The Lived Experience Of Women's Health Centre Coordinators, Jodie L. Moyle

Theses: Doctorates and Masters

The purpose of this phenomenological study is to explore and describe the lived experience of women's health centre coordinators. In addition to the intrinsic value of telling these women's stories, this research provides data which can he used to strengthen the economic, political, organisational and social position of women’s health centres and the women who work in them. Four women managers from regional urban women's health centres in Australia were interviewed about their subjective experiences with respect to their current working roles. Interviews were audio taped, transcribed and coded to produce themes and to preserve anonymity. Data was analysed using …

To Immunize Or Not To Immunize, That Is The Question! An Investigation Into The Reasons Behind Parents' Decisions In Immunizing Their Children Against Whooping Cough In Western Australia, Eliena Kirov

Theses : Honours

Demographic data on the immunization status of Australia indicates that Western Australia has relatively low immunization coverage for whooping cough. Australian quantitative studies have been carried out on parental attitudes in Australia towards immunization, but there has been no analysis of parents' reasons for their decisions. This study identified the key issues that influenced the decisions made by the target group of parents and explored their decision-making in more depth. The data from this study could also be used to supplement the information currently available to health workers. Eight participants with children between the ages of 2 months and 6 …

Classification Of Participants Into Two Health Resource Utilization Groups By The Health Enrollment Assessment Review (Hear) Survey, Jody W. Donehoo

Health Services Research Dissertations

The study examined the ability of the Health Enrollment Assessment Review (HEAR) survey instrument to classify participants into one of two groups according to utilization of health resources anticipated in the following year. Developed by the U.S. Air Force, the HEAR survey is used worldwide by the Department of Defense for enrollees in TRICARE Prime, the military's adaptation of the HMO model of managed care. Individual HEAR reports are prepared for survey participants and their primary care providers in TRICARE Prime. Although it is currently administered worldwide to a majority of the 8.4 million health care beneficiaries of the Department …

The Guillain-Barre Syndrome And The 1992-1993 And 1993-1994 Influenza Vaccines, Tamar Lasky, Gina J. Terracciano, Laurence Magder, Carol Lee Koski, Michael Ballesteros, Denis Nash, Shelley Clarke, Penina Haber, Paul D. Stolley, Lawrence B. Schonberger, Robert T. Chen

Publications and Research

Background
The number of reports of influenza-vaccine-associated Guillain-Barré syndrome to the national Vaccine Adverse Event Reporting System increased from 37 in 1992-1993 to 74 in 1993-1994, arousing concern about a possible increase in vaccine-associated risk.

Methods
Patients given a diagnosis of the Guillain-Barré syndrome in the 1992-1993 and 1993-1994 influenza-vaccination seasons were identified in the hospital-discharge data bases of four states. Vaccination histories were obtained by telephone interviews during 1995-1996 and were confirmed by the vaccine providers. Disease with an onset within six weeks after vaccination was defined as vaccine-associated. Vaccine coverage in the population was measured through a random-digit-dialing …

Assessing The Accuracy Of A New Diagnostic Test When A Gold Standard Does Not Exist, Todd A. Alonzo, Margaret S. Pepe

UW Biostatistics Working Paper Series

Often the accuracy of a new diagnostic test must be assessed when a perfect gold standard does not exist. Use of an imperfect test biases the accuracy estimates of the new test. This paper reviews existing approaches to this problem including discrepant resolution and latent class analysis. Deficiencies with these approaches are identified. A new approach is proposed that combines the results of several imperfect reference tests to define a better reference standard. We call this the composite reference standard (CRS). Using the CRS, accuracy can be assessed using multistage sampling designs. Maximum likelihood estimates of accuracy and expressions for …

Erisa Health Plan Denials: Exploring Models For External Review, Karl Polzer

National Health Policy Forum

This paper outlines the current process under the Employee Retirement Income and Security Act (ERISA) by which plan participants can appeal a claim denial as well as changes to the claims procedure requirements being considered by the Department of Labor. It describes state legislative activity in this area and summarizes research describing practices currently in place among managed health care organization. The paper also describes two existing models for external review of managed care plan decisions, one used by the Medicare program and another by the state of Florida.

Commencement Program 1998, Loma Linda University

Commencement Programs

2 | 1998 Events of Commencement

3 | The Academic Procession

4 | The Speakers

8 | The University Honorees

16 | The School Honorees

26 | The Zapara Award

The Programs

• School of Medicine, 28
• School of Dentistry, 35
• Graduate School, 43
• School of Nursing, 52
• School of Allied Health Professions, 57
• School of Allied Health Professions (Physical Therapy), 65
• School of Public Health, 71

The Relationship Between Tamoxifen And Depressive Symptoms In Women With Breast Cancer, Terry Marie Lynn

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine whether women with breast cancer and the presence of the drug tamoxifen, are more severely depressed than women with breast cancer and the absence of tamoxifen. Average Beck Depression Inventory (BDI) scores did not differ between the two sub-groups; however, two significant group differences were found. First, 10 women in the tamoxifen group had scores of zero (versus 4 in the absence of prescribed tamoxifen group). Research has shown that scores of zero do not always reflect an absence of depression. Second, the most severely depressed women (BDI scores in the 25 …

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Kerala, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, P. R. Murti, Hemali Mehta, Florence Verghese, Mira Aghi, Kamala Krishnaswamy, Fali S. Mehta

Faculty Publications

Objective: To develop and test a food frequency questionnaire (FFQ) for use in rural areas of Kerala, India. Design: Based on food use and market surveys of the study area, a quantitative 81- item interviewer-administered FFQ was developed. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 8 days randomly selected over an entire year and two administrations of the FFQ, one at the beginning of the l-year period and the other at the end. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by examining differences in the nutrient scores. Setting: …

Nursing Home Ownership And Public Policy: An Historical Analysis, K. R. Kaffenberger

Graduate Doctoral Dissertations

In the early days of the United States, care of the disabled elderly outside the home meant the public almshouse. By the 1920s, private, nonprofit homes for the aged were prevalent. More recently, private, for-profit facilities have grown to dominate the field.

For-profit ownership has been controversial. Underlying the controversy is the concern that quality might be lowered in order to enhance profit.

This study asks why most nursing homes are privately owned and why most privately owned nursing homes are operated for profit. It does so with reference to The Nonprofit Economy, in which Burton Weisbrod describes a …

In The Affirmative, Vol.5, No.4 (Mid-April/Mid-May 1998), Mike Martin, The Aids Project

In the affirmative (1993-1999)

No abstract provided.

Impact On Material And Child Health Knowledge As A Result Of Participation In A Family Resource\Youth Services Center New And Expectant Parenting Series, Donna Sims

Masters Theses & Specialist Projects

The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the …

A Longitudinal Study Of Hospitalization Rates For Patients With Chronic Disease: Results From The Medical Outcomes Study., Eugene C. Nelson, Colleen A. Mchorney, Willard G. Manning, W H. Rogers

Dartmouth Scholarship

To prospectively compare inpatient and outpatient utilization rates between prepaid (PPD) and fee-for-service (FFS) insurance coverage for patients with chronic disease. Data from the Medical Outcomes Study, a longitudinal observational study of chronic disease patients conducted in Boston, Chicago, and Los Angeles.A four-year prospective study of resource utilization among 1,681 patients under treatment for hypertension, diabetes, myocardial infarction, or congestive heart failure in the practices of 367 clinicians.

Health Care Quality: From Data To Accountability, Mary Darby

National Health Policy Forum

This paper discussed the evolution of quality measurement and reporting activities as well as efforts to develop accountability for delivering high-quality care. It examined (a) initiatives in the professional arena, such as accreditation and performance measurement by independent accrediting bodies; (b) activities of market proponents, who have preferred to concentrate on making data available to purchasers and consumers that would enable them to choose high- quality plans and providers; and (c) attempts by the public sector to secure quality through regulation and oversight. An exploration of the successes, limitations, overlaps, and gaps in quality assurance initiatives, the paper was published …

Proactive Technique For Workplace Chemical Exposure, James A. Duru

Theses

The rapid increase in the number and quantities of chemicals released into the environment has been accompanied by a lack of adequate pre-released testing for advance health outcomes. Chemicals which serve as feed stock to millions of industries all around the world to produce and process food, cosmetics, equipment, and energy to propel industries, automobiles, home heating and electricity have serious adverse health consequences. They are hazardous. These substances can explode, ignite, react and corrode. Adapting the definition of the international program on chemical safety, a "hazard" is a source of danger. This thesis proposes some proactive prevention techniques useful …

Improving Patient Satisfaction With A Major Healthcare Organization, Mary Carolyn Tornero

Theses Digitization Project

No abstract provided.

Announced To Trounced: A Journalist's Comments On The Demise Of The Tobacco Settlement, Adam S. Levy

Journal of Health Care Law and Policy

No abstract provided.

Tobacco Litigation's Third-Wave: Has Justice Gone Up In Smoke?, David A. Hyman

Journal of Health Care Law and Policy

No abstract provided.

The Future Of The World Health Organization: What Role For International Law?, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Microbialpolitik: Infectious Diseases And International Relations, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Community-Based Aids Prevention And Care In Africa: Results Of Four Action-Research Interventions In East And Southern Africa, Ann Leonard, Esther Muia

HIV and AIDS

The Community Counseling Aides (CCA) project operating with support from the National AIDS Control Programme (NACP) in Uganda, is a government initiative being carried out in collaboration with local communities. As the Ministry of Health seeks to develop local capacity to support and operate these efforts at the community level, it has identified the need to improve the skills of local project staff so that they may begin to assume the responsibility for monitoring and evaluating their own program performance. This is part of an overall strategy on the part of the Ugandan Government to decentralize control and allocation of …

Uncertainty And Variability Analysis In The Estimation Of Human Exposure To Mercury From Seafood Consumption Using Two-Dimensional Monte Carlo Simulations, J. Keith Bangerter

MUSC Theses and Dissertations

Fish and shellfish are a beneficial food source due to their high protein content, low saturated fat content, and low cholesterol content; they possess beneficial omega-3 fatty acids and antioxidants such as vitamin E and selenium. Recent studies identified a decreased risk of sudden cardiac death in seafood consumers. Per capita seafood consumption increased 27% from 1975 to 1990, with nearly 95% of the U.S. population consuming some kind of fish or shellfish product each year. But seafood consumption may pose health risks which need to be weighed against benefits. One of potential risks is the toxicity of methylmercury. Mercury …

Medicaid Recipients Denied Coverage For Smoking Cessation Pharmacotherapy, Kelly N. Reeves

Journal of Health Care Law and Policy

No abstract provided.

Surveillance For Waterborne-Disease Outbreaks -- United States, 1995-1996, Deborah A. Levy, Michelle S. Bens, Gunther F. Craun, Rebecca L. Calderon, Barbara L. Herwaldt

Journal Articles: Epidemiology

PROBLEM/CONDITION: Since 1971, CDC and the U.S. Environmental Protection Agency have maintained a collaborative surveillance system for collecting and periodically reporting data that relate to occurrences and causes of waterborne-disease outbreaks (WBDOs).

REPORTING PERIOD COVERED: This summary includes data for January 1995 through December 1996 and previously unreported outbreaks in 1994.

DESCRIPTION OF THE SYSTEM: The surveillance system includes data about outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and for voluntarily reporting them to CDC on a standard form.

RESULTS: For the period 1995-1996, …

Chain Saw Hazard Alert, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Tractors/Logging

A review of 74 cases of chain saw injuries to Kentucky farmers revealed that most occurred while the farmers were clearing fence lines. Most of the injuries occurred in the spring, from March through April, and in the fall, from October through November. As for time of day, most happened in the morning, from 8:30 to 10, and in the early afternoon, from 12 to 3.

Described below are two representative incidents, followed by recommendations for prevention of similar injuries.

Integrating Sti/Hiv Services Into Existing Mch/Fp Programs, Baker Ndugga, Ian Askew

Reproductive Health

The presence of certain STIs increases the risk of the sexual transmission of HIV. Thus, controlling STIs can reduce the incidence of HIV. Almost all women in the East and Southern African regions attend MCH/FP clinics regularly, and recent surveys have shown that the prevalence levels of many STIs, including HIV, can be high for women seeking FP and antenatal services, even though they are frequently asymptomatic. MCH/FP services are provided by medically trained staff with many of the same skills needed for managing STIs. Consequently, several MCH/FP programs have started looking for ways to integrate STI management strategies, such …