Digital Commons Network^™

Role Of Lifestyle And Aging On The Longitudinal Change In Cardiorespiratory Fitness, Andrew S. Jackson, Xuemei Sui, James R. Hébert, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF.

Methods - We studied a cohort of 3429 women and 16,889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness …

Gangguan Akibat Kekurangan Iodium Di Indonesia: Tinjauan Epidemiologis Dan Kebijakan Kesehatan, Laurentius Aswin Pramono

Kesmas

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Pada masa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi terhadap permasalahan GAKI di …

How To Build A Health Clinic: Disease Burden, Health Seeking Behavior And Clinic Structures In The Kibera Slums, Samuel Mcgowan

Independent Study Project (ISP) Collection

This study seeks to determine a model for a health clinic to be run by the Kibera School for Girls in the Katwekera village of Nairobi’s Kibera slums. The study examines the disease burden of the school’s initial target population, the health-seeking behavior of the community, and current clinic structures in Kibera. Using these methodological tactics, the study suggests the Kibera School for Girls should start a small, locally-run clinic that offers basic primary health care to a target population of about 5,000 Kibera residents.

The Impact Of Brazil’S Bolsa Familia Program On Food Security In Santo Antônio De Jesus, Bahia, Mario Felipe Dest

Independent Study Project (ISP) Collection

The purpose of this research project is to evaluate the impact that the Bolsa Família Program has on the level of food security within an impoverished community of Santo Antônio de Jesus. The issue of food security is important because a person’s overall health worsens as a result of not having access to a healthy and well balanced diet. As a result of these negative health aspects, one’s capacity to do work, learn, and take care of one’s family are all affected. This relationship between nutrition and social situations is the focus of this study, which will be used to …

Breastfeeding: A Landmark In Global Public Health, Melissa Tinling

Independent Study Project (ISP) Collection

In the study of public health and the discipline of global health, what is the meaning of the term “global public health”? The author, Melissa Tinling, defines the concept and gives an illustration through the model of the global effort to increase breastfeeding prevalence. Using the WHO and UNICEF joint Global Strategy for Infant and Young Child Feeding as the central framework, the responsibilities of the global, international, national, and local levels are depicted within the context of Geneva, Switzerland. The author identifies the ethical considerations implicated in the application of the global public health strategy to breastfeeding.

Kibera Community Unconscious Of The Silent Disease: Sti, Sindhya Rajeev

Independent Study Project (ISP) Collection

The objective of this study was to conduct a Sexually Transmitted Infections (STI) Awareness Survey that explores knowledge about STIs and attitude towards them, and thereafter, institute and implement an educational intervention in the Kibera slum, of Nairobi. The survey included 120 participants from the 12 villages of Kibera. It revealed that, of those interviewed, 34% are unable to name an STI other than HIV/AIDS and 99% are unaware of any of the syndromes associated with STIs. This demonstrated a clear need for STI Awareness and education, and thus an informative brochure on STIs was created, to be distributed during …

Download Full Pdf Issue Of Jefferson School Of Population Health Master Of Public Health E-News Public Health Link, Vol. 5, Iss. 2, Fall 2009.

Public Health Link

This Issue includes:

MPH spotlight on Priscilla Sepe, MD/MPH student

Students Advocate for Public Health Education at National Summit in D.C.

A re-accreditation update

Department of Health & Human Services Region III Office—Clerkship Experience

Listing of upcoming bag lunch and learns

National Public Health Meetings in Philadelphia this Fall

Public Health Policy & Advocacy Opportunities

Lamu Sensitive Aid: Barriers To Distribution, Acceptance, And Use Of Malaria Prevention In Lamu District, Kelan Stoy

Independent Study Project (ISP) Collection

his study examines how organizations work locally to distribute malaria aid and education for malaria prevention. Additionally, it analyzes the effectiveness this aid has in improving malaria preventative techniques used by the people of Lamu District. This effectiveness was compared in the contexts of several regions of the district to further understand differences in rural and urban settings. Information was gathered using a variety of interviews with organizations and prominent community leaders to gauge their ideas on malaria in Lamu and strategies used to prevent it, and informal field interviews to observe different communities’ perspectives on malaria and also their …

Quality Health Information On The Internet: Developing A Diabetes Pathfinder For The Chinese Population, Ana D. Cleveland, Jodi Philbrick, Xuequn Pan, Xinyu Yu, Jiangping Chen, Marty O'Neill, Lisa Smith

Faculty Publications

A Web-based bilingual diabetes information pathfinder was created to help the Chinese population access quality health information on the Internet as part of a collaborative outreach project in the Dallas-Fort Worth area. A survey was conducted to identify the demographics, Internet usage, health information needs, and preferences for training sessions of the Chinese population. Breast cancer, diabetes, and hepatitis B were the top three diseases of interest. The process of developing the pathfinder is described from start to finish, and it can serve as a model for the development of others. Pathfinder training sessions also were held. Taylor & Francis …

National Health Accounts: Lessons For Pakistan, Muhammad Ashar Malik

Community Health Sciences

No abstract provided.

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, …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

Development And Formative Implementation Of A Nutrition Assessment And Peer Education Program Based On Dietary Analysis At A California State University, Janay Jelso

Master's Theses

A healthy diet has been established as a key component contributing to an individual’s quality of life. Statistics show that the diet of Americans needs improvement (Guenther et al., 2007) indicating possible lack knowledge of what healthy eating behaviors are. There is an abundance of nutrition misinformation available to the consumer (American Dietetic Association, 2002a). Dietary interventions that provide credible education based on readiness to change behaviors and goal setting have been successful in increasing awareness of what healthy eating behaviors are and changing existing behaviors over time (Ammerman et al., 2002; Evans & Sawyer-Morse, 2002; Gambera et al., 1995; …

Senate Bill 42: Implementation And Impact On Physical Activity In Middle Schools, Cristina S. Barroso, Steven H. Kelder, Andrew E. Springer, Carolyn L. Smith, Nalini Ranjit, Christopher Ledingham, Deanna M. Hoelscher

Health & Human Performance Faculty Publications

Purpose

In 2005, the Texas State Legislature passed Senate Bill 42 (SB42), which required public middle school students (grades 6–8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity.

Methods

Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n = 112). Direct observation, …

Coverage And Payment For Prescription Drugs Under Medicare Part B: A Complex Patchwork, Amanda Cassidy

National Health Policy Forum

As part of the diverse discussions around health care reform, many have looked to refining Medicare payment systems as a way to give health care practitioners and providers greater incentives to deliver care more efficiently, and thus slow health care spending growth. Understanding how Medicare currently pays for Part B services, including drugs covered under Part B, is essential to understanding the potential impact of these types of reforms. Most items and services covered under Part B, including most Part B drugs, are paid individually, which means practitioners and providers generally receive more payments for providing more services. Some reform …

Pengaruh Kemiskinan Keluarga Pada Kejadian Pneumonia Balita Di Indonesia, Rizanda Machmud

Kesmas

Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis …

Makanan Etnik Minahasa Dan Kejadian Penyakit Jantung Koroner, Grace Debbie Kandou

Kesmas

Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

Birth Weight As A Risk Factor For Breast Cancer: A Meta-Analysis Of 18 Epidemiologic Studies, Xiaohui Xu, Amy B. Dailey, Mary Peoples-Sheps, Evelyn O. Talbott, Ning Li, Jeffrey Roth

Health Sciences Faculty Publications

Background: Birth weight has been identified as a birth-related factor associated with the risk of breast cancer. However, the evidence is inconsistent.

Methods: To investigate the association between birth weight and breast cancer, we conducted a meta-analysis of published studies between 1996 and 2008. Eighteen studies encompassing 16,424 breast cancer cases were included in the meta-analysis. Data were combined using a fixed-effect or random-effect model depending on the heterogeneity across studies.

Results: Women with their own birth weight >4000 g or 8.5 lb had a higher risk for developing breast cancer than those with birth weight(OR¼1.20, 95% CI 1.08, 1.34). …

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …

The Effects Of Physical Activity And Nutrient Intake On The Risk Of Hip Fracture : Results From The Adventist Health Study-2, Wen-Ling Liao

Loma Linda University Electronic Theses, Dissertations & Projects

This is a two year of follow up study of Adventist Health Study-2 (AHS-2). We assessed the association between physical activity, nutrient intake and risk of hip fracture among peri- and post menopausal Caucasian women using unconditional logistic regression models. All subjects completed a lifestyle questionnaire which including information of physical activity and frequency and portion size of food intake at enrollment into the study (2002-2007). The “Bi-Annual Hospitalization History” questionnaire which included a question about hip fractures due to minor trauma/falls was sent to subjects approximately two years after enrollment, with a response rat of 82.84%. In this cohort, …

Effect Of California Mission Fig Consumption On Levels Of C-Reactive Protein And Antioxidant Levels, Rasha Abdrabou

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols exert anti-inflammatory and antioxidant effects. We investigated the effect of consumption of polyphenol-rich figs on high sensitivity C-reactive protein (CRP) and antioxidant levels in hyperlipidemic subjects. The purpose of this study was to examine the effect of fig consumption on C-reactive protein and antioxidant levels. Analyses were carried out on collected data from September to December of 2008. Using a crossover design, one hundred and two participants were recruited and randomized into an intervention phase (eating figs) and a control phase (not eating figs) for 5 weeks. Blood samples were drawn from each group at the 4th and 5th …

Physiological Changes And Participation To Exercise In Older Adults Living In Age Restricted Communities, Mary F. Shaughnessy

All-Inclusive List of Electronic Theses and Dissertations

It is known that the aging population is more susceptible to musculoskeletal and metabolic disease and would benefit from a regular exercise program. The primary objective of this study was to evaluate whether older adults (55 years of age and older) participation in a more regular exercise program would increase if there was supervision from a health professional. The second objective was to evaluate whether supervision in a regular exercise program would show physiological benefits. Subjects were recruited from three age-restricted communities; however one community was disregarded due to lack of subjects. A physical activity plan based on the American …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Community Health Centers In Indiana: State Investments And Returns, Avi Dor, Patrick Richard, Ellen Tan, Sara J. Rosenbaum, Peter Shin, Lee Repasch

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Indiana Community Health Centers (I-CHC), including Federally Qualified Health Centers (FQHCs) and State Funded Health Centers (SFHCs), play a vital role in caring for the state's most vulnerable populations. Although their patient base tends to be poorer and experience greater health challenges than the general population, these health centers have generated substantial health care savings while providing high quality, low cost care. In this brief, key findings are presented from a recent study, conducted for the Indiana State Department of Health by GWU faculty and staff that was designed to estimate the cost savings and benefits generated by the state's …

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Carbohydrate Intake And Overweight And Obesity Among Healthy Adults, Anwar T. Merchant, Hassanali Vatanparast, Shahzaib Barlas, Mahshid Dehghan, Syed Mahboob Ali Shah, Lawrence De Koning, Susan E. Steck

Faculty Publications

Background - Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective - To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults

Design - We used a cross-sectional analysis

Subjects/setting - The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures - Outcome variables were body mass index (BMI; calculated as kg/m^{2 …}

Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study, Chinelo A. Ogbuanu, Janice C. Probst, Sarah B. Laditka, Jihong Liu, Jongdeuk Baek, Saundra Glover

Faculty Publications

Purpose - Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics.

Methods - Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n = 2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ^{2 …}

Bridging The Gaps: Biomedicine, Complementary And Alternative Medicine In A Holistic Approach, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

The 4^th international conference on holistic health and medicine was held during September 24-26, 2008 in Lexington, Kentucky in the United States of America. This conference brought many participants from 23 countries, both mainstream health care providers as well as holistic health practitioners to address the latest in knowledge and research, and in turn to find ways to collaborate and work together to provide the best possible care for their patients and clients. These conferences are held to build bridges between the various fractions of medicine and health care providers. The scientific program included plenary sessions, keynotes, workshops and …

Commencement Program 2009, Loma Linda University

Commencement Programs

CONTENTS

2 | 2009 Events of Commencement

3 | The Academic Procession

4 | Significance of the Academic Regalia

5 | The Good Samaritan

6 | The Speakers

13 | The University Honorees

19 | The School Honorees

30 | The Program

• School of Medicine, 31
• School of Pharmacy, 46
• School of Dentistry, 51
• School of Science and Technology and School of Religion, 63
• School of Nursing, 71
• School of Allied Health Professions - Physical Therapy, 78
• School of Allied Health Professions, 86
• School of Public Health, 95