Medicine and Health Sciences Commons^™

Never Smokers -- Are They More Sensitive To The Respiratory Health Effects Of Ambient Air Pollution?, Zuhair Saleh Natto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Several studies show an association between ambient particulate matter (PM) and all-cause mortality. The Adventist Health and Smog 1 (AHSMOG-1) study (N=6,338) has previously found associations between ambient air pollution and incident chronic obstructive pulmonary disease (COPD) using the spatial interpolation method from the three nearest fixed monitoring stations to residence and workplace. However, few studies have assessed the risk of death among disease specific subgroups such as those with COPD.

Objectives: The aims of this study were 1) to assess the effect of chronic exposure to ambient air pollutants on risk of all-cause mortality among persons with COPD …

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

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 …

Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to assess the effect of long-term concentrations of ambient PM on risks of all causes, cardiopulmonary, coronary heart disease (CHD), total cancer, and any mention of nonmalignant respiratory disease (NMRD) mortality.

The health effects of long-term ambient air pollution have been studied with up to 30 years of follow-up in the AHSMOG cohort, a cohort of 6,338 nonsmoking white California adults. Monthly concentrations of ambient air pollutants [particulate matter(PMio), Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2) or particulate matter

In the AHSMOG cohort, each increment of 10 |ig/m3 in PMio in two-pollutant models …

Anthropometric Parameters Of Under-Five Years Old Children With Different Dietary Habits In Ukambani Region : A Study In Eastern Rural Kenya, Hellen M. Ndiku

Loma Linda University Electronic Theses, Dissertations & Projects

The objective of this descriptive cross sectional study was to assess dietary intake and nutritional status of children under-five years in two rural sites of Eastern Kenya where the staple cereals may differ. A modified rapid, knowledge, practice and coverage (KPC) questionnaire and a 24-hr dietary recall form were used to collect the data. A total of 403 households were surveyed from four randomly selected divisions. This yielded 629 surrogate 24-hr dietary recalls of children < 5 years with 314 from Mwingi district and 315 from Makueni district (49 % boys and 51 % girls).

Statistical analysis was done using SPSS and SAS. Comparison of means was done using t- test and chi square was used for proportions. The 24-hr …

Knowledge, Perceptions, Beliefs And Behaviors Related To The Prevention Of Hypertension Among Black Seventh-Day Adventists Living In London, Maxine A. Newell

Loma Linda University Electronic Theses, Dissertations & Projects

This study was a cross-sectional survey of the hypertension (HTN) knowledge and risk behaviors of Black Seventh-day Adventists (SDA) in London. Recruitment took take place in 17 predominantly Black SDA churches in London. A questionnaire assessed knowledge and lay-beliefs about HTN and perceptions towards HTN using the health belief model (HBM) constructs of susceptibility, severity, benefits, barriers, and self-efficacy. Cohen’s Perceived Stress Scale was incorporated into the questionnaire. Blood pressure, height, weight and waist circumference were and current lifestyles practices were evaluated for the presence of HTN risk factors.

Of the 312 volunteers, ages 25 to 79, 55% were born …

Efficacy Of Cognitive Therapy And Pharmacotherapy In Depression: A Meta-Analysis, Daniel B. Michel

Loma Linda University Electronic Theses, Dissertations & Projects

A meta-analysis comparing the long-term effectiveness of cognitive behavioral therapy (CBT) and pharmacotherapy in preventing relapse following treatment discontinuation was performed using published studies of depressed participants. Twenty-three articles met inclusionary criteria and were included in the analyses. Weighted effect sizes and moderators, treatment type, were calculated using statistical analysis software. Initially, fixed effects models were applied to the data, but due to significant between-group heterogeneity that could not be fully explained by treatment type, mixed effect models were used to account for the residual heterogeneity. Results indicated that overall, depressed individuals treated to remission with CBT evidence decreased relapse …

The Association Between Lifestyle Factors And Inflammatory Markers, Kerry Ann Stonebrook

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States. While smoking, high blood pressure, and elevated cholesterol levels are established risk factors for CVD, inflammation is being evaluated as a potential independent risk factor. A key cytokine regulator of the inflammatory response, interleukin-1 (IL-1), has emerged as playing a particularly important role at the genetic level in determining the degree to which the inflammation pathway is turned on. How an individual’s genetic make-up affects inflammation, CVD risk, and response to lifestyle intervention is an area of research that is in …

Cultural And Psychological Influences On Diabetic Adherence, Keikilani Mcmillin-Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes mellitus is a serious disease that poses a particular healthcare challenge because progression is considered controllable (Cox, et al, 1985; Vinicor, et al, 1996) yet treatment adherence, and thus outcome, is very poor (Gonder-Frederick, Cox, & Ritterband, 2002; Goodall, 1991). Culture is a lethal risk factor for diabetic contraction and treatment maintenance. Latinos within the United States are two-to-three times more likely to develop complications and die than non-Latinos (Haffner et al, 1996; Rubin, Peyrot, & Saudek, 1991) and are less likely to adhere to treatment (Lipton, Losey, Giachello, Mendez, & Girotti, 1998). Efforts to eliminate health disparities have …

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 …

Does The Oswestry Or Sf-36 Help A Therapist To Predict Treatment Classification, Amy Crawford, Denese D. Kaufeldt-Soliz

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the relationship of two disability questionnaires, the Oswestry Low Back Pain Disability Questionnaire (Oswestry) and the Medical Outcome Study Short Form-36 (SF-36), and a standardized physical examination and diagnostic classification system. The physical examination was performed by the evaluating therapists from the clinic and classification was determined by the evaluating therapists and the investigators to ensure correct subject placement into treatment Stages la, lb, or II. Data collection occurred at an outpatient physical therapy clinic in a metropolitan area health maintenance organization, where a sample of 221 subjects with low back pain …

The Relationship Of Dietary And Lifestyle Factors To Bone Mineral Density Of Healthy Singaporean Chinese Women, Ampai Dana Aimsiri

Loma Linda University Electronic Theses, Dissertations & Projects

Few studies have examined the risk factors associated with reduced bone mass in Asians, but none specifically investigated Singaporean Chinese women. The subjects in this study were 16 premenopausal, 8 perimenopausal and 13 postmenopausal women who participated in a larger study which began in 1986. Bone density was measured in 1986 and 1992. Dietary and lifestyle data were collected for this study by personal interview. Association between dietary and lifestyle factors and bone density variables and change in bone density at the end of the 6 year period were assessed by univariate regression analyses.

Postmenopausal women had significantly lower baseline …

Condylar Angulations As Related To Submental-Vertex Radiographs, Jady L. Chiakowsky

Loma Linda University Electronic Theses, Dissertations & Projects

Pretreatment submental-vertex radiographs were obtained for 637 adolescent patients (307 males, 330 females) who had presented themselves for orthodontic treatment. The purpose of this study was to: (1) determine the relationship between condylar angulations and depth of cut with the variables: age, sex, and race, and (2) establish normative values for the categories studied. The results indicated that no significant differences existed between the condylar angulations for the variables measured. However, significant differences did exist between the depth of cut for the variables measured and there was significant interaction between age and race with respect to the depth of cut. …

A Flow Cytometric Analysis Of Immunocyte Populations In Peripheral Blood And Pleural Effusions Of Patients With Cancer, Mandy L. Bohn

Loma Linda University Electronic Theses, Dissertations & Projects

Two-color flow cytometric analysis was performed on paired samples of peripheral blood (PB) and pleural effusions (PE) of patients with metastatic malignancies. The purpose of these analyses was to test the hypothesis that there are significant differences in the distribution of immunocyte populations in the PE compared to that of the PB.

The majority of the pleural fluid immunocytes were CD3+ cells. The ratio of CD4+ to CD8+ cells was higher in the PE compared to PB. Levels of CD8+, CD19+ and CD14+ cells were not significantly different in the PE compared to the levels in the PB. CD16+CD56+ cells …

Effect Of Photoperiod On Developmental Morphology And Enolase Isoenzyme Immunohistochemistry In Rat And Djungarian Hamster Superficial Pineal Glands, Chalmer D. Mcclure

Loma Linda University Electronic Theses, Dissertations & Projects

The best understood functional activity of the pineal gland is its diurnal production of melatonin in response to environmental lighting cues. Several enzymes of the melatonin pathway respond to daily photoperiod changes, for example hydroxyindole-O-methyltransferase (HIOMT) and serotonin N-acetyltransferase (SNAT). Increased levels of the glycolytic enzyme neuron-specific enolase (NSE) are thought to reflect increased physiological demands placed on neurons and neuroendocrine tissues. Homodimer non-neuronal enolase isoenzyme (NNE) is immunolocalized to cells, and the hybrid enolase (consisting of subunits from NSE and NNE) has been seen in cerebellar stellate and basket cells. Although not rate limiting, concentrations of both NSE and …

Decreased Triiodothyronine Binding To The Hepatic Nuclear Thyroid Hormone Receptor In The Diabetic Mouse, Thomas J. Dewind

Loma Linda University Electronic Theses, Dissertations & Projects

The diabetic C57BL/KsJ-db m mouse has abnormal thyroid hormone levels and indications of thyroid hormone resistance. To investigate the basis of these abnormalities, the hepatic nuclear thyroid hormone receptor was extracted with 0.4 M KCl, 1.1 mM MgCl₂, 20 mM Tris/HCl, pH 7.9 from hepatocyte nuclei of normal C57BL/KsJ, heterozygous C57BL/KsJ-db m (db/m), and diabetic C57BL/KsJ-db m (db/db) mice. Normal and heterozygous mice were grouped together as the controls. Triiodothyronine (T₃) binding studies at 4°C using nitrocellulose filtration to separate free T₃ from receptor bound T₃ demonstrated an …

Time Delayed Protein Complementation, Diana L. Lakusta

Loma Linda University Electronic Theses, Dissertations & Projects

The time delayed complementation of plant proteins was tested in weanling Sprague-Dawley male rats by measuring growth rates as well as plasma and tissue free amino acids. Diets of pinto beans with rice, corn or wheat were pair-fed in combination or alternating 4 times a day at 6 and 11 am, and 4 and 9 pm for 4 weeks. Plasma, liver and muscle samples were obtained 2 hours postprandial, a time determined most suitable for sacrifice, and analyzed for free amino acids via ion-exchange chromatography. There were no significant differences in growth of rats fed combination or alternating diets.during week …

The Effect Of Dietary Fat Level On Tumor Development And Immunity In Balb/C Mice Fed Casein Of Wheat Gluten As Protein And Challenged With Herpes Type 2-Transformed Cells, Helen Drakou

Loma Linda University Electronic Theses, Dissertations & Projects

A high percentage of fat in the diet has been implicated through epidemiological studies in several human cancers. Studies in experimental animals have produced evidence that increasing the fat in the diet decreases the animal’s ability to restrict tumor development and growth. In previous work done in this laboratory with BALB/c mice injected with herpes simplex Type 2-transformed mouse cells (H238), the effects of a diet which greatly enhanced tumor growth was compared with one which restricted tumor growth. The latter, a low (5%) fat, low protein diet, in which the protein was casein, was also found to produce a …

A Sensitivity Analysis Of The Coefficients For The Transformation Of The Electrocardiographic Orthogonal Three-Lead System (Frank) To The Standard Twelve-Lead System, Rasa Ona Draugelis

Loma Linda University Electronic Theses, Dissertations & Projects

The SENSITIVITY ANALYSIS is performed on the transformation coefficients of the Frank XYZ signals generating standard 12-lead ECG with respect to diagnosis. The analysis is adapted for the individual waveform and per each lead. The disease/abnormality categories are described in terms of discrete pattern classes based on criteria used by Marquette Electronics, Inc. The nonlinear global sensitivity analysis method developed by Shuler, et al, is selected for this project. The diagnostic change in the waveform is denoted by a distance measurement from the pattern class boundary corresponding to the best-experimental coefficient estimates (Dower coefficients) to the alternate coefficient specification measurement …

Chronic Respiratory Disease Symptom Effects Of Long-Term Cumulative Exposure To Passive Tobacco Smoke And To Ambient Levels Of Tsp, Oxidants, So2, And No2 In Southern California, Gary L. Euler

Loma Linda University Electronic Theses, Dissertations & Projects

To assess risk of chronic respiratory disease symptoms due to long-term exposure to the ambient levels of TSP, oxidants, SO2 and NO2 in photochemical air pollution, symptoms were ascertained using NHLBI questions on 8,572 Southern California Seventh-day Adventist, nonsmokers, 25 years and older, who lived eleven years or longer in their 1977 residential area. Tobacco smoke, active and passive, and occupational exposures were measured by questionnaires, as well as lifestyle characteristics relative to pollution exposure such as time spent outside and residence history. A pulmonary function feasibility study was done on a subsample of 86 women 50-64 years of age …

The Effect Of Hypercholesterolemia On The Membrane Lipids, 3-0-[¹⁴C] Methylglucose Transport, And 2,3-Diphosphoglycerate Levels In Rat Erythrocytes, Edwin J. Lester Jr.

Loma Linda University Electronic Theses, Dissertations & Projects

An increase in dietary cholesterol and cholic acid will produce hypercholesterolemia in rats. For ten months, two groups of rats (six in each group) were fed commercial rat pellets (control group) or rat pellets plus cholesterol (1%) and cholic acid (0.25%) (experimental group). A blood sample from each animal was divided into three aliquots for three separate experiments on the erythrocytes: a membrane cholesterol and phospholipid determination, a 3-0-[¹⁴C] methylglucose (30MG) transport determination, and a 2,3-diphosphoglycerate (2,3 DPG) determination. The 30MG transport and 2,3 DPG aliquots were each incubated in the same five concentrations of 30MG and glucose …

Review Of Prognostic Factors For Esophageal Voice, Christine G. Bravos

Loma Linda University Electronic Theses, Dissertations & Projects

Plan A of this study was completed. Plan B of the study is the subject for future research. A review of the laryngectomy literature, from the earliest mention of the laryngectomy surgical procedure to the present was conducted; with specific emphasis upon factors pertinent to laryngectomee rehabilitation and esophageal speech development. Psychological, idiosyncratic, social, therapeutic and physiological factors were reported as affecting esophageal voice development. There were a great diversity of variables that might be predictive in judging acquisition of esophageal voice. However, much of the information regarding predictive variables was based on subjective reports, poorly controlled statistical research, or …

Models For Estimating Psychiatric Bed Needs, Patricia A. Brenneman

Loma Linda University Electronic Theses, Dissertations & Projects

Inland Counties Comprehensive Health Planning Council wished to estimate the psychiatric bed needs by type (such as state hospitals, board and care homes, etc.) in San Bernardino County from the distributions of patient arrivals and of lengths of stay. A statistical description of the system during 1973 was considered the first step toward estimating future bed needs. A computer simulation model using IBM's programming language General Purpose Simulation System (GPSS) was developed and was found to be unsatisfactory.

Theorems were then developed for a statistical model, seeking to predict future bed needs. The most convenient of these theorems states that …

Exploration Of The Incidence Of Identified Emotional Disorders In Selected General Hospitals Of Nebraska, Arlene M. Van Horn

Loma Linda University Electronic Theses, Dissertations & Projects

A descriptive-comparative survey using content analysis of medical records has been done to determine the frequency with which emotional disorders are identified by medical personnel in the population hospitalized in small general hospitals in north-central Nebraska.

A systematic, random sample of medical records was taken from two hospitals arbitrarily included in the study on the basis of bed capacity and distance from mental health facilities.

Each medical record that was reviewed has been placed in a category based on whether an emotional disorder was identified in it by the medical personnel, or whether it contained recorded behaviors that could indicate …

Leadership Techniques In Groups With Chronic Schizophrenics, Judith L. Jensen, Leona W. Mcgrew

Loma Linda University Electronic Theses, Dissertations & Projects

The study was designed to assess the level of anxiety experienced by chronic schizophrenic patients when two different methods of leadership were used in group therapy. A search of literature revealed suggestions for modification of leadership approach due to the tenuous anxiety tolerance of chronic schizophrenics but no studies were found directly related to the amount of anxiety resulting from different leadership approaches.

A structured group in which the leader maintained a directive role was compared with a nonstructured group in which the leader maintained a nondirective role in the group process. The randomized sample included five male and five …

A Community Health Nursing Care Plan, Gayle Clark

Loma Linda University Electronic Theses, Dissertations & Projects

Structured nursing care plans are recognized tools in the effective utilization of the nursing process. Community health nursing services have not commonly used structured nursing care plans. The purpose of this study was to improve the management of patient problems through the deliberate use of the nursing process by providing the public health nurse with a structured nursing care plan. A plan was developed which consisted of a nursing history outline, a plan for action tool, and an evaluation form.

The nursing problem of milk anemia was selected to be managed by public health nurses in the study. Six nurses …

Relationship Of Ventilation Ability And Positioning In Left-Sided Congestive Heart Failure Patients, Nancy E. Carson

Loma Linda University Electronic Theses, Dissertations & Projects

Proper positioning is used to relieve dyspnea, edema, and fatigue in congestive heart failure patients. According to the review of literature, improved ventilation as measured by specific lung volumes and lung mechanics occurred with upright positioning in normal persons. The effects of specific changes in lung volumes related to position change in congestive heart failure patients has not been documented in literature, although various recommendations related to positioning are made. This exploratory study was undertaken with nine congestive heart failure patients to see if a relationship existed between degree of head elevation and lung ventilation ability as measured by water-bell …

A Study To Demonstrate The Immediate Destination Of An Embolus Formed In The Lumen Of A Peripheral Venous Catheter, Rosemarie Morikone Emori

Loma Linda University Electronic Theses, Dissertations & Projects

This study was designed to show the immediate destination of an embolus formed in the lumen of an intravenous catheter placed in a peripheral vessel. The hypothesis stated that clots injected into a peripheral vessel will lodge in the lungs. A subhypothesis was that the clot may lodge anywhere along the circulatory pathway.

Indications of need for the study as shown by the review of literature were the following: (1) the complications resulting from the frequent use of intravenous polyethylene catheters, (2) experimental studies that showed that clots were formed around intravenous catheters, (3) the evidence that intravenous catheters predispose …

Roentgenographic Evaluation Of Nasion-Menton And Sella-Gonion Measurements And Their Relationship To The Mandibular Plane Angle, David I. Asatani

Loma Linda University Electronic Theses, Dissertations & Projects

A convenience sample of 480 Caucasians using original diagnostic cephalometric films was selected to evaluate the nasion-menton and sella-gonion distances and their relationship to the mandibular plane angle.

The anterior facial height was represented by the nasion-menton plane. The posterior facial height was represented by sella-gonion plane. The facial depth was represented by sella-nasion and menton-gonion planes. The mandibular plane angle was represented by the intersection of the sella-nasion and menton-gonion planes.

The descriptive data, correlation analysis, and regression analysis was calculated for the following groups: total sample, females, males, prepubertal and postpubertal ages and various mandibular plane angles of …