Digital Commons Network^™

Public Health Abstracts 2004

Florida Public Health Review

No abstract provided.

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

Comparison Of Two Approaches To Structured Physical Activity Surveys Of Adolescents, Robert G. Mcmurray, Kimberly B. Ring, Margarita S. Treuth, Gregory J. Welk, Russell R. Pate, Kathryn H. Schmitz, Julie L. Pickrel, Vivian Gonzalez, Maria João C. A. Almeida, Deborah Rohm Young, James F. Sallis

Faculty Publications

Purpose - To compare the test-retest reliability, convergent validity, and overall feasibility/usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents.

Methods - Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph^® accelerometer for the same period.

Results - The TB instrument took about 3 min longer to complete (P=0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r=0.676 and 0.667), but the girls …

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy With Traditional Diagnostic Procedures, Neil I. Goldfarb, Laura T. Pizzi, Joseph P. Fuhr Jr., Christopher Salvador, Vanja Sikirica, Asher Kornbluth, Blair Lewis

College of Population Health Faculty Papers

The purpose of this study was to review economic considerations related to establishing a diagnosis of Crohn's disease, and to compare the costs of a diagnostic algorithm incorporating wireless capsule endoscopy (WCE) with the current algorithm for diagnosing Crohn's disease suspected in the small bowel. Published literature, clinical trial data on WCE in comparison to other diagnostic tools, and input from clinical experts were used as data sources for (1) identifying contributors to the costs of diagnosing Crohn's disease; (2) exploring where WCE should be placed within the diagnostic algorithm for Crohn's; and (3) constructing decision tree models with sensitivity …

Mainecare Behavioral Health Care Expenditures State Fiscal Years 1996 – 2002, Susan Payne Phd, Stuart Bratesman Mpp, David Lambert Phd

Disability & Aging

No abstract provided.

Clinical Implications Of Obesity With Specific Focus On Cardiovascular Disease: A Statement For Professionals From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism, Samuel Klein, Lora E. Burke, George A. Bray, Steven N. Blair, David B. Allison, Xavier Pi-Sunyer, Yuling Hong, Robert H. Eckel

Faculty Publications

Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides …

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

A Study Of Pediatric Heart Transplant Patients In Relationship To Post Transplant Coronary Artery Disease, Mark Randall

Loma Linda University Electronic Theses, Dissertations & Projects

Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. Objective: The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) …

The Provider System For Children's Mental Health: Workforce Capacity And Effective Treatment, Jane Koppelman

National Health Policy Forum

This issue brief examines two issues that are key to meeting children’s unmet needs for mental health care: ensuring that the provider supply is adequate and that the care delivered is effective. It describes the shortage of qualified providers to address children’s mental disorders, as well its possible causes; it describes how managed care, to a certain extent, drives practice patterns; and it discusses the gray areas in deciding which providers are most qualified to deliver what care. In addition, this paper introduces what is known about evidence-based care in children’s mental health, the extent to which it is being …

Mental Healthcare In A Rural Community, Thuy Nguyen

Independent Study Project (ISP) Collection

This study intends to observe and document the picture of mental health in a rural setting specifically, the Keiskamahoek area. Also, the project aims to evaluate the changes, if any exist, that resulted from recent attempts to integrate mental healthcare into the primary healthcare setting and bring psychiatric patients back to the community environment for treatment.

Answering The Earthquake, Thomas G. Plante

Psychology

During the past several years, the American Catholic Church has suffered an enormous earthquake due to the child sexual abuse crisis that was initially reported on January 6, 2002 by the Boston Globe Spotlight Team. Although the sexual abuse of children by priests had been in the news many times before, the recent case in Boston 14 Conversations resulted in perhaps the largest earthquake ever in the American Catholic Church. While the epicenter of the quake was centered in Boston, there were many significant aftershocks felt across the land. Sadly, Jesuits and Jesuit universities were not immune from the recent …

Indigenous Healing Practices And Their Effect On Tb And Hiv/Tb Patients’ Utilization And Compliance With Anti-Tb Medication, Josephine Thinwa

Independent Study Project (ISP) Collection

A sample of 27 Tuberculosis patients attending New Brighton Clinic in small urban community for treatment were surveyed and interviewed on their use of alternative treatments and interpretation of TB. This study specifically focused on TB patients’ use of traditional medicine in treating TB and whether this use had an effect on the patients’ willingness to utilize and adherence to anti-TB treatment from the clinic. Investigations were also done to characterize if an HIV positive status influenced TB patients’ inclination to utilize traditional medicine. Through a focus group discussion with three traditional healers, information was provided on traditional medicine and …

Cervical Cancer Screening In Rural South Africa: An Analysis Of The Awareness, Attitudes, And Practices Of Women Served By The Masincedane Clinic, Jordan Schneider

Independent Study Project (ISP) Collection

The aim of this study was to conduct a brief investigation into the awareness, attitudes and practices regarding cervical cancer among women living in Keiskammahoek, a rural area in the Eastern Cape of South Africa. The objectives of this study were to:

• Determine if screening is available within a localized rural community and the methods that are being used.

• Determine if women are coming in for screening, the demographics of these women, and the circumstances that bring them into PHC clinics.

• Investigate the level of knowledge and education about cervical cancer and prevention among women within the …

A Marginal Model Approach For Analysis Of Multi-Reader Multi-Test Receiver Operating Characteristic (Roc) Data, Xiao Song, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

The receiver operating characteristic (ROC) curve is a popular tool to characterize the capabilities of diagnostic tests with continuous or ordinal responses. One common design for assessing the accuracy of diagnostic tests is to have each patient examined by multiple readers with multiple tests; this design is most commonly used in a radiology setting, where the results of diagnostic tests depend on a radiologist's subjective interpretation. The most widely used approach for analyzing data from such a study is the Dorfman-Berbaum-Metz (DBM) method (Dorfman, Berbaum and Metz, 1992) which utilizes a standard analysis of variance (ANOVA) model for the jackknife …

Re-Engineering Systems For The Treatment Of Depression In Primary Care: Cluster Randomised Controlled Trial, A. J. Dietrich, Thomas E. Oxman, John W. Williams Jr., Herbert C. Schulberg, Martha L. Bruce, Pamela W. Lee, Sheila Barry

Dartmouth Scholarship

Objective: To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources.

Physical Activity In A Cohort Of Medicaid Beneficiaries With Physical Impairments: Recruitment And Outcomes, Craig Ravesloot Ph.D., James Laskin Ph.D., Melody Huskey M.A., Sara Laney, Nancy Cherot, Huw Griffiths, Barbara Cowan, Lisa Brennan M.L.S., Catherine Ipsen, Sheri Martinez, Ann Szalda-Petree Ph.D., Rod Brod, University Of Montana Rural Institute

Health and Wellness

This document reports on research conducted by the University of Montana for the Office of Disability and Health at the Centers for Disease Control and Prevention. The research project, conducted between September 30, 2000 and September 29, 2004 was accomplished in three separate but related studies. The research was conducted at the New Directions programs, a community-based health promotion and wellness clinic operated through the rural Institute on Disabilities at the University of Montana. We collaborated with the State Department of Medicaid to recruit Medicaid beneficiaries with mobility impairments in Missoula County to participate in the research. We recruited 368 …

Cultural Value Orientations, Attributions, And Breast Cancer Screening Behaviors, Patricia M. Flynn

Loma Linda University Electronic Theses, Dissertations & Projects

Discrepancies in breast cancer screening behavior exist among various ethnic groups in the United States (Jacobs & Lauderdale, 2001), with Latino American women reporting particularly low screening rates in comparison to Anglo American women (ACS, 2002). Research indicates that behavior is in part influenced by aspects of culture and relevant psychological processes (Betancourt & Lopez, 1993; Betancourt & Fuentes, 2001). This study was designed to investigate the relations among cultural values, attributional processes, and breast cancer screening behavior among Anglo and Latino women. This study also investigated the influence of acculturation among Latino women in relation to the other study …

Pediatric Obesity: Intervention Outcomes, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

Childhood obesity is a national epidemic with serious medical and psychological implications. Almost one-fourth of children in the United States are overweight. Children do not typically grow out of obesity and without intervention the majority of overweight children become overweight adults. Further, childhood obesity results in numerous chronic medical conditions. Thus, the prevention and treatment of childhood obesity are paramount to the avoidance of resultant physical and psychological risk factors. Loma Linda University’s Growing Fit Program seeks to serve the critical and urgent needs of the ever-increasing population of obese children with a multi-disciplinary approach to pediatric weight management. Evaluating …

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 …

A Report From The Forum Session "Implementing The New Medicare Drug Benefit: Challenges And Opportunities For States", Judith D. Moore

National Health Policy Forum

The National Health Policy Forum convened a meeting on July 22, 2004 to discuss state-based challenges associated with implementing the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The meeting brought together an extremely insightful and experienced group of current and former state officials and other experts to discuss key issues. In keeping with its tradition of promoting a frank, off-the-record exchange on health policy issues, NHPF does not normally prepare written summaries or reports of meetings. However, because this meeting provided vivid illustrations of the importance of state-federal collaboration for the successful implementation of the new Medicare drug benefit, …

Quality Of Life In The Chronically Mentally Ill: Impact Of Demographics, Symptomatology, And Coping Styles, Dawn Castner

All-Inclusive List of Electronic Theses and Dissertations

Schizophrenia and schizoaffective disorder are often persistent and disabling conditions that require a wide range ofbiopsychosocial treatments. In recent decades, treatment has largely focused on assisting persons to maintain community tenure, while little attention has been devoted to quality of life. For many, these illnesses have a negative impact on life satisfaction due to their chronic and variable nature, lack of completely efficacious treatments, and social stigma. Some have speculated that various demographic, symptom, or treatment variables influence quality of life, but the nature and amount of influence is uncertain. 111 The purpose of this study was to investigate the …

Will Knowledge Of Green Tea Benefits Influence Coffee Consumption?, I-Fang Wang

All-Inclusive List of Electronic Theses and Dissertations

Many recent studies have focused on the health benefits of green tea consumption. Although there is conflicting evidence, there is a strong trend showing positive effects of green tea to human health. This current study was done to explore whether the knowledge of such green tea benefits will influence the willingness of coffee drinkers to consider switching to green tea consumption. The survey study included a convenience sample of 132 adults who considered themselves regular coffee drinkers. From the statistical analyses of the collected data, results were obtained primarily through frequency distributions and phi coefficients. Data analysis suggested a significant …

Body Image, Emotional Regulation, And Binge Eating In Obese Females, Courtney D. Stahl

All-Inclusive List of Electronic Theses and Dissertations

Individuals with binge eating disorder (BED) tend to endorse significant overconcerns with weight and shape and a greater propensity to eat in response to negative mood states. The primary aim of this study was to examine the impact of body image disturbance on the self-regulation of affect in female obese non-binge (n=46) and binge eaters (n=l09). Groups were similar in age (M=46.3) and race (84% Caucasian). Obese non-binge eaters were significantly less obese (BMI=35.50) than their binge eating counterparts (BMI=38.60). On the Multidimensional Body Self-Relations Questionnaire (MBSRQ), obese binge eaters endorsed significantly higher levels of body dissatisfaction, greater feelings of …

Frequency Of Mental Health Service Use In School-Based Health Centers: School Performance And Family Characteristics, James William Depetro

All-Inclusive List of Electronic Theses and Dissertations

Public schools and community health organizations have created partnerships to provide mental health services to children. One such collaboration has led to the development of School-Based Health Centers (SBHC). SBHC provide mental health services in an attempt to enhance students' development and performance. The research findings regarding SBHC impact on school performance are mixed (Gall, Pagano, Desmond, Perrin, & Murphy, 2000; McCord, Klein, Foy, & Fothergill, 1993; Weist, Proescher, Freedman, Paskewitz, & Flaherty, 1995; Wolk & Kaplan, 1993 ). The purpose of this research study was to determine if the frequency of use of mental health services at SBHC are …

Non-Parametric Estimation Of Roc Curves In The Absence Of A Gold Standard, Xiao-Hua Zhou, Pete Castelluccio, Chuan Zhou

UW Biostatistics Working Paper Series

In evaluation of diagnostic accuracy of tests, a gold standard on the disease status is required. However, in many complex diseases, it is impossible or unethical to obtain such the gold standard. If an imperfect standard is used as if it were a gold standard, the estimated accuracy of the tests would be biased. This type of bias is called imperfect gold standard bias. In this paper we develop a maximum likelihood (ML) method for estimating ROC curves and their areas of ordinal-scale tests in the absence of a gold standard. Our simulation study shows the proposed estimates for the …

Social Support Protects Against The Negative Effects Of Partner Violence On Mental Health, Ann L. Coker, Paige H. Smith, Martie P. Thompson, Robert E. Mckeown, Lesa Bethea, Keith E. Davis

CRVAW Faculty Journal Articles

Objectives: Social support for abused women may reduce the impact of abuse on mental health, yet few studies have addressed this issue. We wish to determine associations between intimate partner violence (IPV) and mental health outcomes and to assess the protective role of abuse disclosure and support on mental health among abused women.

Methods: A cross-sectional survey was conducted of 1152 women, ages 18–65, recruited from family practice clinics from 1997 through 1999. They were screened for IPV during a brief in-clinic interview, and physical and mental health status was assessed in a follow-up interview.

Results: IPV, defined as sexual, …

Defining Accelerometer Thresholds For Activity Intensities In Adolescent Girls, Margarita S. Treuth, Kathryn H. Schmitz, Diane J. Catellier, Robert G. Mcmurray, David M. Murray, Maria João C. A. Almeida, Scott Going, James E. Norman, Russell R. Pate

Faculty Publications

Purpose - To derive a regression equation that estimates metabolic equivalent (MET) from accelerometer counts, and to define thresholds of accelerometer counts that can be used to delineate sedentary, light, moderate, and vigorous activity.

Methods - Seventy-four healthy 8th grade girls, age 13-14 yr, were recruited from urban areas of Baltimore, MD, Minneapolis/St. Paul, MN, and Columbia, SC, to participate in the study. Accelerometer and oxygen consumption (VO₂) data for 10 activities that varied in intensity from sedentary (e.g., TV watching) to vigorous (e.g., running) were collected. While performing these activities, the girls wore two accelerometers, a heart …

Comparison Of Medical Subject Headings And Text-Word Searches In Medline To Retrieve Studies On Sleep In Healthy Individuals, Elizabeth Sergeevna Jenuwine, Judith A. Floyd

Nursing Faculty Research Publications

Objective: The objective was to investigate the performance of two search strategies in the retrieval of primary research papers containing descriptive information on the sleep of healthy people from MEDLINE.

Methodology: Two search strategies - one based on the use of only Medical Subject Headings (MeSH), the second based on text-word searching - were evaluated as to their specificity and sensitivity in retrieving a set of relevant research papers published in the journal Sleep from 1996 to 2001 that were preselected by a hand search.

Results: The subject search provided higher specificity than the text- word search …

Commencement Program 2004, Loma Linda University

Commencement Programs

CONTENTS

2 | 2004 Events of Commencement

3 | The Academic Procession

4 | Significance of Academic Regalia

5 | The Speakers

12 | The University Honorees

19 | The School Honorees

27 | The Program

• School of Medicine, 28
• School of Dentistry, 35
• Graduate School, 44
• School of Nursing, 54
• School of Allied Health Professions - Physical Therapy, 59
• School of Allied Health Professions, 65
• School of Public Health, 73

The Association Of Blood Type On The Five Factors Of Personality In Chinese Adolescents, Kunher Wu

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the number of personality factors in Chinese adolescents using the Chinese Revised NEO Personality Inventory (NEO-PI-R) and to determine whether blood type is associated with personality. It is widely accepted by psychologists that the five-factor model can provide an adequate representation of adult personality dimensions, but there is less agreement on the number of factors observable in adolescence. A total of 3,396 11^th graders from the city of Kaohsiung, Taiwan completed the Chinese NEO-PI-R. Principle component analysis with varimax rotation showed five factors of personality in these Taiwanese adolescents, which clearly …