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An Assessment Of The Community Based Distribution Programs In Ghana, Jane Chege, Diouratie Sanogo, Ian Askew, Angela Bannerman, Steve Grey, Evam Kofi Glover, Francis Yankey, Joana Nerquaye-Tetteh

Reproductive Health

This study was carried out to describe the major NGO community-based distribution (CBD) programs in Ghana, and to assess in some detail the functioning, quality of care, and performance of the Planned Parenthood Association of Ghana (PPAG) program. The study showed that national coverage by the NGO programs is extensive—virtually all the 110 districts in the 10 regions have at least one program. However, coverage within districts is sparse, as each program covers only a few communities. The results have been communicated to the NGOs whose programs were included in the study and PPAG has already identified a number of …

Integrating Men Into The Reproductive Health Equation: Acceptability And Feasibility In Kenya, Esther G. Muia, Violet Kimani, Ann Leonard

Reproductive Health

This study’s objective was to improve understanding of Kenyan men’s actual and potential roles as supportive partners in various phases of reproductive health (RH), to help in the design of strategies to encourage men’s greater participation in a variety of RH initiatives in Kenya. The results of the study clearly show that, to a larger extent than anticipated, men in Kenya already participate in women-centered RH services. Overall the institutional barriers seemed to be more overwhelming than the cultural barriers, given that one of the reasons frequently given for nonparticipation was fear of non-acceptance by the health providers. Based on …

Rights, Technology, And Services In Reproductive Health: A Report From A Meeting, Marion Carter, C. Elizabeth Mcgrory

Reproductive Health

The Population Council’s Robert H. Ebert Program on Critical Issues in Reproductive Health convened a two-day meeting to explore some of the compelling issues at the intersection of technology, services, and rights. Nearly 70 professionals from the research, policy, service delivery, human rights, and advocacy fields came together to grapple with some of the political aspects of reproductive technologies. Participants also discussed how these technologies can facilitate or constrain rights, depending on the interests involved and the particular social, political, and economic contexts in which they are used. This report on the meeting concludes that in order for program managers …

Mali: Les Exciseuses Persistent Malgré Les Supplications, Frontiers In Reproductive Health

Reproductive Health

No abstract provided.

Enhancing The Use Of Emergency Contraception In A Refugee Setting: Findings From A Baseline Survey In Kakuma Refugee Camps, Kenya, Esther G. Muia, Joyce Olenja

Reproductive Health

In August 1992, the International Rescue Committee (IRC) at the request of the United Nations, the United Nations High Commission for Refugees, and the Kenyan Government, initiated a primary health care program in the Kakuma Refugee Camp. Since then, the population of the camp has continued to grow, and activities have moved from a crisis to a maintenance phase. In January 1997, IRC assumed the additional responsibility of the camp hospital, bringing the entire health sector under their management. IRC's programs focus on maintaining and improving public health and promoting self-reliance, particularly of the most vulnerable communities. This project focuses …

Factors Associated With Healthy Eating: Attitudes, Cultural Adherence, And Snacking Behavior Among Korean-American Adolescents, Kyoung Eun Oh

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescents have increased nutrition needs and report frequent meal skipping and snacking, but there are few studies that examine the determinants of unhealthy eating, especially among ethnic minority groups. This study investigated dietary intake and snacking behavior among Korean-American adolescents in the Los Angeles area. We determined the relationship between dietary fat intake and overall quality of the diet as assessed by two healthy eating indices: the Healthy Eating Index (HEl) and Mean Nutrient Adequacy Ratio (MNAR). HEl assessed degree of compliance to Food Guide Pyramid and Dietary Guidelines for Americans while MNAR assessed nutrient consumption compared to Recommended Dietary …

Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert

Loma Linda University Electronic Theses, Dissertations & Projects

A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.

Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …

The Effect Of Stress And Genetic Factors On Alcohol Consumption Among Males In Olancho District, Honduras, Gloria Amanda Madrid

Loma Linda University Electronic Theses, Dissertations & Projects

Alcoholism is a major public health problem globally. More than twenty studies have examined the association between the neurotransmitter dopamine DRD2 TaqI polymorphism and the onset of alcoholism, with half supporting an association. This study was based on the assumption that there is a relationship between the presence of the DRD2, one’s exposure to stress, and alcohol consumption. We examined the gene-stress interactional model in a sample of 309 males of Mayan descendents in the Olancho district of Honduras (age range 18-87). Participants were interviewed by a health care professional and blood samples were obtained for genetic identification. The Michigan …

Predicting Milk And Soft Drink Consumption Among Female Adolescents Using The Theory Of Planned Behavior, Nada Osman Kassem

Loma Linda University Electronic Theses, Dissertations & Projects

A total of 756 female adolescents, aged 13 to 18 years, from five public high schools in Antelope Valley Union High School District located in North Los Angeles County participated in this study between February 1999 and March 1999. The ethnic composition was 53.3% White/Anglo Americans, 19.3% Hispanics or Latinos and 10.2% Black/African Americans. The constructs of the Theory of Planned Behavior (attitude, subjective norm, and perceived behavioral control and their underlying beliefs) were assessed to determine the predictors of low-fat milk and regular soda consumption. A cross-sectional design with group-administered questionnaires was utilized.

Most participants (89.6%, n = 636) …

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 …

Cardiovascular Disease Prevention By Sports: Myth Or Reality?, Maria João C. A. Almeida, Steven N. Blair

Faculty Publications

Low levels of physical activity and fitness substantially increase risk of several chronic diseases, reduce longevity, and lead to loss of function. The strength and relation of inactivity to health problems and the high prevalence of sedentary habits in most countries of the world make lack of exercise a major public health problem. Fortunately, there is now good consensus regarding public health recommendations for physical activity from many important medical, scientific, and public health organizations. Recent research on physical activity interventions provides additional approaches to helping sedentary adults become more physically active.

Tracking Of Physical Activity, Physical Inactivity, And Health-Related Physical Fitness In Rural Youth, Russell R. Pate, Stewart G. Trost, Marsha Dowda, Alise E. Ott, Dianne S. Ward, Ruth P. Saunders, Gwen A. Felton

Faculty Publications

This study examined the tracking of selected measures of physical activity, inactivity, and fitness in a cohort of rural youth. Students (N=181, 54.7% female, 63.5% African American) completed test batteries during their fifth- (age=10.7±0.7 years), sixth-, and seventh-grade years. The Previous Day Physical Activity Recall (PDPAR) was used to assess 30-min blocks of vigorous physical activity (VPA), moderate-to-vigorous physical activity (MVPA), TV watching and other sedentary activities, and estimated energy expenditure (EE). Fitness measures included the PWC 170 cycle ergometer test, strength tests, triceps skinfold thickness, and BMI. Intraclass correlation coefficients (ICCs) for VPA, MVPA, and after-school EE …

Validity Of The Previous Day Physical Activity Recall (Pdpar) In Fifth-Grade Children, Stewart G. Trost, Dianne S. Ward, Ben Mcgraw, Russell R. Pate

Faculty Publications

This study evaluated the validity of the Previous Day Physical Activity Recall (PDPAR) self-report instrument in quantifying after-school physical activity behavior in fifth-grade children. Thirty-eight fifth-grade students (mean age, 10.8 ± 0.1; 52.6%; female; 26.3% African American) from two urban elementary schools completed the PDPAR after wearing a CSA WAM 7164 accelerometer for a day. The mean within-subject correlation between self-reported MET level and total counts for each 30-min block was 0.57 (95% C.I., 0.51-0.62). Self-reported mean MET level during the after-school period and the number of 30-min blocks with activity rated at > 6 METs were significantly correlated with the …

Update: West Nile Virus Encephalitis — New York, 1999, Centers For Disease Control And Prevention, Denis Nash

Publications and Research

The West Nile virus (WNV) encephalitis outbreak continues to wane in the Northeast with the onset of cooler temperatures and continued vector-control operations. This report updates the progress of the ongoing investigation. Since the last published update (1), five additional domestic human cases and one international case have been identified. As of October 19, 56 (31 confirmed and 25 probable) cases of WNV infection have been identified, including seven deaths (Figure 1). The date of onset of the latest cases was September 22. The international case was a Canadian citizen who had visited the New York City (NYC) area in …

Update: West Nile-Like Viral Encephalitis — New York, 1999, Centers For Disease Control And Prevention, Denis Nash

Publications and Research

The outbreak of human arboviral encephalitis attributable to a mosquito-transmitted West Nile-like virus (WNLV) continues to wane in the Northeast (Figure 1). As of October 5, the number of laboratory-positive cases had increased to 50 (27 confirmed and 23 probable), including five deaths. The increase in cases is mainly a result of completed retesting with West Nile virus antigen of specimens previously tested with the related St. Louis encephalitis virus antigen and to intensive retrospective case finding in the ongoing epidemiologic investigations (1,2).

Outbreak Of West Nile-Like Viral Encephalitis -- New York, 1999, Centers For Disease Control And Prevention, Denis Nash

Publications and Research

An outbreak of arboviral encephalitis was first recognized in New York City in late August and has since been identified in neighboring counties in New York state. Although initially attributed to St. Louis encephalitis (SLE) virus based on positive serologic findings in cerebrospinal fluid (CSF) and serum samples using a virus-specific IgM-capture enzyme-linked immunosorbent assay (ELISA), the cause of the outbreak has been confirmed as a West Nile-like virus based on the identification of virus in human, avian, and mosquito.

The Nursing Center In Concept And Practice: Delivery And Financing Issues In Serving Vulnerable People, Karen Matherlee

National Health Policy Forum

This issue brief looks at ways in which nurse-managed centers — with support from the Health Resources and Services Administration and private foundations — are carving a role in providing preventive and primary care to vulnerable populations. Two case studies — one in Philadelphia and the other in the Utah-Nevada border area — llustrate nursing centers' mission, outreach, services, workforce, payment concerns, and educational tie-ins.

Quality Of Care In Investor-Owned Vs Not-For-Profit Hmos, David U. Himmelstein, Steffie Woolhandler, Ida Hellander, Sidney M. Wolfe

Publications and Research

Context The proportion of health maintenance organization (HMO) members enrolled in investor-owned plans has increased sharply, yet little is known about the quality of these plans compared with not-for-profit HMOs.

Objective To compare quality-of-care measures for investor-owned and not-for-profit HMOs.

Design, Setting, and Participants Analysis of the Health Plan Employer Data and Information Set (HEDIS) Version 3.0 from the National Committee for Quality Assurance's Quality Compass 1997, which included 1996 quality-of-care data for 329 HMO plans (248 investor-owned and 81 not-for-profit), representing 56% of the total HMO enrollment in the United States.

Main Outcome Measures Rates for 14 HEDIS quality-of-care …

Dietary Assimilation Of Cadmium Associated With Bacterial Exopolymer Sediment Coatings By The Estuarine Amphipod Leptocheirus Plumulosus: Effects Of Cd Concentration And Salinity, Christian E. Schlekat, Alan W. Decho, G. Thomas Chandler

Faculty Publications

Bacterial extracellular substances (also known as exopolysaccharides, or EPS) may serve as vectors for trophic transfer of metals in benthic systems because these ubiquitous sediment coatings can sorb high concentrations of toxic metals, and because many benthic invertebrates assimilate EPS sediment coatings upon ingestion. We conducted 3 sets of experiments to determine the assimilative bioavailability of EPS-associated Cd to the benthic amphipod Leptocheirus plumulosus as a function of Cd concentration and salinity. Bioavailability was measured as L. plumulosus Cd assimilation efficiency (AE) from EPS-coated silica (EPS●Si) and from uncoated silica (NC●Si) using modified pulse-chase methods with the gamma-emitting radioisotope ^{109 …}

Canada's Generalist Training: Are There Lessons For The United States?, Lee Hawkins

National Health Policy Forum

Addressing the premise of an inappropriate skewing of the U.S. medical education system toward specialty medicine, this issue brief compares and contrasts the U.S. and Canadian graduate medical education (GME) systems, including the organization and financing of each. The issue brief also explores various lessons that might be learned from the Canadian GME system, such as full integration of primary care and GME and the use of incentives to achieve desired policy goals.

Commencement Program 1999, Loma Linda University

Commencement Programs

CONTENTS

2 | 1999 Events of Commencement

3 | The Academic Procession

4 | The Speakers

9 | The University Honorees

15 | The School Honorees

The Programs

• School of Medicine, 23
• School of Dentistry, 30
• Graduate School, 38
• School of Nursing, 47
• School of Allied Health Professions - Physical Therapy, 52
• School of Allied Health Professions, 58
• School of Public Health, 65

Ethnic Intercession: Leadership At Kalaupapa Leprosy Colony, 1871–1887, Pennie Moblo

Pacific Studies

Western notions of leadership can obscure the complexity of colonial history. This article examines ethnic relations in Hawai‘i via its Hansen’s disease colony during the years immediately preceding the overthrow of the monarchy. Popular accounts of Kalaupapa portray a nineteenth-century prison of iniquity where native Hawaiians, sequestered from the controls of civilization, degenerated to a state of “savagery” until a European priest saved them. This image is challenged by letters and reports to the Board of Health, which invoke an alternative history focused on the dialogue between native patients and foreign advisors in government. It is argued here that the …

Contributors: Vol 22 No. 2, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Contributors list of Vol. 22 (1999): Pacific Studies Full Issue 2

Books Received And Book Notices, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Book Listing for the Vol 22, No 2 Edition of the Pacific Studies Journal

Vol. 22 No. 2 (1999): Pacific Studies Full Issue, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Pacific Studies is published two times a year by The Jonathan Nāpela Center for Hawaiian and Pacific Studies, Brigham Young University Hawai‘i #1979, 55–220 Kulanui Street, Lāʻie, Hawai‘i 96762, but responsibility for opinions expressed in the articles rests with the authors alone. Subscription rate is US$40.00 yearly, payable to The Jonathan Nāpela Center for Hawaiian and Pacific Studies. The Jonathan Nāpela Center for Hawaiian and Pacific Studies (formerly The Pacific Institute) is an organization funded by Brigham Young University Hawai‘i. The Center assists the University in meeting its cultural and educational goals by undertaking a program of teaching, research, and …

Recidivism Among Jamaican Teenage Mothers : A Historical Cohort Study 1995-1998, Vonna Lou Caleb Drayton

Loma Linda University Electronic Theses, Dissertations & Projects

Pregnancy is the single most important reason why girls fail to complete secondary school in the Caribbean. The Women's Centre of Jamaica Foundation (WCJF) Program was established in 1978 to enable adolescent mothers 16 years and under to return to school, and to delay second pregnancies until completion of their education.

This historical cohort study assessed the effect of the WCJF Program on the incidence of repeat pregnancies over the period 1995-1998, and on the educational attainment of program participants. A random sample (n=260) of primiparous Jamaican adolescent mothers 12-16 years who gave birth in 1994 in the parishes of …

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

Screening Seniors For Risk Of Functional Decline: Results Of A Survey In Family Practice, Dawn M. Dalby, John W. Sellors, Fred D. Fraser, Catherine Fraser, Cornelia Van Ineveld, Laura Pickard, Michelle Howard

Kinesiology and Physical Education Faculty Publications

To measure functional status, determine risk of functional decline and assess consistency between responses and standardized instruments. Design: A mailed survey which measured functional impairment, recent hospitalization and bereavement. A positive response on at least one of these factors indicated that the individual was “at risk” for functional decline. A random sample (n=73) of “at risk” subjects (specifically, family practice patients aged 70 and older) were assessed by a nurse. Results: The response rate was 89% (369/415), 59% of seniors were female and the mean age was 77.1 (SD=5.5) years. Self-reported risk, based on activities of daily living (ADLs), was …

Books Received And Book Notices, The Jonathan Nāpela Center For Hawaiian And Pacific Islands Studies

Pacific Studies

Book Listing for the Vol 22, No 1 Edition of the Pacific Studies Journal

Welfare Reform And Its Impact On Medicaid: An Update, Judith D. Moore

National Health Policy Forum

Welfare reform, enacted in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), had a profound impact on the Medicaid program, delinking Medicaid from the new TANF program and for the first time allowing Medicaid eligibility to be divorced from welfare status. This paper reviews the national impact of this decoupling, describing research, implementation activities, and the impact of new state welfare programs on health programs in general.