Medicine and Health Sciences Commons^™

Predictors Of Aggression Among Adolescent Girls, Sarah Joy Park

Loma Linda University Electronic Theses, Dissertations & Projects

Women and girls will often deny what they feel and think to maintain their relationships. Silencing the self can be detrimental to the physical and mental health of teenage girls. This stifling of the self is related to depression, earlier first intercourse, eating disorders, and less relationship satisfaction. Girls who silence their voices are also likely to have difficulty expressing themselves when they feel angry. In this study we explored the relationship between silencing the self and physical, verbal, and indirect aggression. Our sample consisted of 88 teenage girls from two high schools, with a mean age of 16. They …

Using The Theory Of Planned Behavior To Understand Student Compliance To Tobacco-Free Policies In California Universities, Harit Agroia

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In California, the mortality rate associated with smoking ranks as the sixth highest among all states in the nation (CDPH, 2016). To reduce this rate, many universities in California have adopted tobacco-free policies in recent years (Mamudu, Veeranki, Kioko, Boghozian & Littleton, 2016). Due to the recent adoption of such policies, there is limited research available which aim to assess the effectiveness of these on tobacco use behavior on campus among university students.

Purpose: The purpose of this study was to understand student compliance to tobacco-free policies within select universities in California, specifically those that implemented their …

Behavioral Ecology And Associated Virology Of Mosquito-Host Interactions In Southern California, Oliver Eshun

Loma Linda University Electronic Theses, Dissertations & Projects

Elucidating characteristics of mosquito-host interactions are critical for understanding the ecology and epidemiology of mosquito-borne diseases. In this dissertation, I conducted three studies to explore potential mosquito-host interactions and associated virus infection rates. I first demonstrated that mosquito captures at CO2-baited traps decreased most markedly with height above ground, and also decreased with distance from water at a riparian area but not at an open water source lacking a vegetated border. Birds might therefore prefer elevated nests or roosts to avoid mosquitoes. The second study examined the anti-mosquito behaviors of budgerigars (Melopsittacus undulatus) in a laboratory study. The birds defended …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

Experiences Of Nurses And Midwives During The Ebola Outbreak In Liberia, West Africa, Erhuvwukorotu S. Kollie

Loma Linda University Electronic Theses, Dissertations & Projects

The 2014 – 2015 Ebola outbreak in the West African region resulted in many deaths and has been responsible for devastating health and socioeconomic upheaval. The decision of nurses and midwives whether or not to render care during outbreaks is vital for the containment of the disease. The purpose of this study was to explore the experiences of nurses and midwives during the Ebola outbreak in Liberia. A grounded theory method based on Corbin and Strauss (2015) and Charmaz (2014) was used, resulting in a conceptual model describing the process involved in the work decisions made by the study participants. …

Vegetarian Dietary Patterns: Mortality, Colorectal Cancer, And Food Consumption, Michael John Orlich

Loma Linda University Electronic Theses, Dissertations & Projects

Objective Vegetarian dietary patterns represent longstanding, real-world diets consumed by a minority of persons. Studies of important health outcomes of such diets, particularly for all-cause mortality and colorectal cancer risk, have yielded inconsistent results. We sought to examine these outcomes (mortality and colorectal cancer incidence) in a large North-American cohort. We also sought to further characterize potentially important differences in the food consumption patterns of these diets. Design Baseline diet was measured by a quantitative food frequency questionnaire among more than 96,000 Seventh-day Adventists in the US and Canada, enrolled from 2002-2007. Dietary patterns were defined, based on the reported …

Acculturation And Cardiovascular Behaviors Among Adult Asian-Americans, Monideepa Bhattacharya Becerra

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The World Health Organization recommends the promotion of positive cardiovascular behaviors (healthy diet and physical activity), while reducing negative ones (tobacco and alcohol abuse) as critical steps in reducing the burden of cardiovascular diseases. Researchers have highlighted the role of acculturation in predicting such behaviors among immigrants, though similar studies among Asian-American subgroups are lacking. This study examines the putative relationship between acculturation and aforementioned cardiovascular behaviors among six Asian-American subgroups.

Methods: A secondary analysis of the California Health Interview Survey 2007, 2009, and 2011 public access data was conducted. Acculturation was assessed utilizing proxy measures of language spoken …

Association Of Dietary Intake Patterns With Emotion Regulation, Megan Holt

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Western dietary patterns, characterized by high intakes of trans fatty acids (TFA’s), are associated with numerous preventable chronic diseases. Conversely, a Mediterranean dietary pattern is known to be favorably associated with health. Recent findings suggest a correlation between Mediterranean dietary patterns and positive affect, and an inverse correlation with negative affect. Trans fatty acid intake is also associated with negative affect. Further, affect disturbances are associated with emotion dysregulation. We have yet to understand the association of diet with emotion regulation after taking affect disturbances into consideration. The purpose of this study was to examine effects of Mediterranean diet …

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 …

Perceived Attitudes And Staff Roles Of Community Based Outpatient Clinics In Disaster Management, Pauline Antoinette Hodge-Hilton

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Natural and manmade disasters have claimed the lives of thousands of individuals in the US and caused billions of dollars in property damage. First responders carry the responsibility of disaster management, leaving other health care professionals such as medical clinic staff underutilized to support the clinic staff. We explored how medical and support staff in Community-based Outpatient VHA Clinics (CBOC) perceive their roles in disaster response, their attitudes about clinic readiness and continuity of care during disasters, and their ability to function in a post disaster environment.

Methods: A mixed method study was conducted to answer questions related to …

The Effects Of Socioeconomic, Built Environment, And Food Environment Factors On Childhood Obesity In Montclair, California, Krystal Redman

Loma Linda University Electronic Theses, Dissertations & Projects

This observational study examines the relationship between socioeconomic status (SES), built environment, and food environment factors and childhood obesity. In this study, the participants were selected from three elementary schools located in the innercity of Montclair, California. Information about each student’s health and family income and was gathered. In addition, the number of parks, fast food restaurants, and grocery stores within the school district border lines were tallied. I also observed the quality of the parks and food sold in the markets, built environment I hypothesized that childhood obesity is associated with SES (i.e., income level and education level), the …

Fetal Programming And Later Obesity In A Predominantly Latino Wic Population, Eric George Walsh

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In utero stressors may work to program the metabolism of the developing fetus in such a way that predisposes him/her to obesity later on. Studies have shown that breastfeeding is protective against childhood obesity and suggest that after six months the weight gain in breastfed babies slows opposed to formula fed babies who continue with rapid weight gain. This slowing of weight gain has been shown to be protective against adiposity and later life weight gain.

Purpose: This study looks to further explore these findings in a low income Latino population adding mother’s feelings about the pregnancy and the …

Successful Aging And Creativity : An Investigation On Functional Status And Psychological Wellbeing In Older Adults, Mirie E. Levy

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: While the literature supports the maintenance of functional status as integral to successful aging, the relationship of creativity on functional status has received little attention. Creativity has been associated with health and aging in the research but only a small number of studies have examined creativity interventions to enhance functional status and boost psychological wellbeing.

Methods: A pretest-posttest quasi-experimental design was used to investigate an 8-week creativity intervention on functional status and psychological wellbeing in older adults. Sample subjects were 92 men and women all over age 60. A series of two-way mixed ANOVAs measured differences between treatment and …

Family Acculturation And Asthma Outcomes In Latino Children, Tania M. Barreno

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Asthma is the primary chronic disease diagnosed in children. California has had some of the highest asthma prevalence rates within the nation. The literature indicates that there is a poor understanding of asthma outcome and management. However, studies exploring the role of acculturation on such outcomes are limited. Thus, the goal of this research was to conduct a secondary analysis of the Child Questionnaire from the California Health Interview Survey (CHIS) 2007 and 2009 cross-sectional data to explore the determinants of asthma outcomes as it relates to family acculturation.

Methodology: The quantitative data were analyzed using Stata. Descriptive statistics, …

Ontogeny Of Venom Use And Venom Composition In The Western Widow Spider Latrodectus Hesperus, David Roger Nelsen

Loma Linda University Electronic Theses, Dissertations & Projects

I investigated the behavioral ecology of venom and venom use by the western widow spider (Latrodectus hesperus), emphasizing the role of ontogeny. In an introductory paper, I reviewed existing definitions of venom and poison, and refined these by adding a third category of toxic biological secretions: toxungen. These three can be distinguished by mode of toxin delivery and presence of a wound. In the first of four empirical studies, I investigated venom use by adult females in the context of threat assessment. A single brief poke at the lowest threat level elicited primarily avoidance responses ("move" and "retract"), repeated prodding …

The Public Health Impact Of Maternal Smoking Cessation During Pregnancy : The San Bernardino County Experience, Michael Batech

Loma Linda University Electronic Theses, Dissertations & Projects

Most studies of maternal tobacco cessation during pregnancy have estimated measures of effect that can be useful in identifying the exposure as an etiologic risk factor in maternal and child health. However, in the case of maternal tobacco use there is overwhelming evidence for a causal role in adverse infant outcomes, and public health needs to focus on measures of potential impact in order to better prioritize and allocate resources toward interventions. The aims of this dissertation were: 1) to investigate the public health impact of smoking cessation during pregnancy among mothers giving birth in San Bernardino County, California; and …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Beliefs About Complementary And Alternative Medicine In Hiv-Infected Black Women Using The Theory Of Planned Behavior, Stephanie G. Lino

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Black women make up 12% of the female population in the U.S, yet they account for 66% of new HIV infections. In 2002, AIDS was the most cited reason for death among Black women age 25-34. While prevention remains, a major effort targeting treatment efficacy and modalities for this sub-group need to be better understood.

Purpose. The purpose of this study is to assess whether HIV-positive Black women’s attitudes, subjective norms and perceived behavioral control are related to intention of dietary supplements and spiritual practices use in their HIV treatment.

Method. In phase one, Grounded Theory methods (N= …

The Association Of Diet And Physical Activity With Stroke Mortality Results From The Adventist Health Study-1, Tahereh Zamansani

Loma Linda University Electronic Theses, Dissertations & Projects

Stroke is one of the leading causes of death and disability, with major global public health implications. Stroke ranks No. 4 among all causes of death, behind heart disease, cancer, and chronic lower respiratory disease (CLRD). Stroke accounts for almost 1 of every 18 deaths in the United States. Women accounted for 60.6% of stroke deaths. Death certificate data show that the mean age at stroke death was 79.6 years; males had a younger mean age (76.3) than females.

There is still a great scientific uncertainty among researchers and epidemiologists about the magnitude of any preventive effect, mechanisms of action …

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, …

Breastfeeding Attitudes And Intentions Among Middle Eastern Women Living In Southern California, Christina Irsilious Fam

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Breastfeeding is unsurpassed as the preferred method of feeding infants all over the world due to the fact that its benefits far outweigh those of infant formula. Mothers from all cultures prefer breastfeeding, yet with immigration and emigration so widespread from developing countries, women's value systems are changing to adapt to their new surroundings. The United States has experienced a great influx of Middle Easterners; California in particular has a dominant presence of Middle Easterners. Many are faced with obstacles and stresses in acculturation, which may lead to lack of breastfeeding their infants. Few studies are available on Middle …

Relationship Between Nut Consumption And Memory Domains Of Cognitive Function Among Elderly Seventh-Day Adventists, Angeline B. David

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. To determine the relationship between consumption of all types of nuts, tree nuts, and peanut and peanut butter and specific memory domains of cognitive function in a community-dwelling elderly population.

Design. Cross-sectional analysis using clinic data from the Biopsychosocial Religion and Health Study and dietary intake data from the Adventist Health Study-2.

Subjects/Methods. Adults aged 50 and older were administered the California Verbal Learning Test-II (CVLT) Short Form and provided self-report frequency and portion sizes of nut consumption, anthropometric measures, and other demographic, lifestyle, and clinic data. CVLT scores were age- and gender-strata specific z-scores normed to a …

Effects Of Photovoice On Youth Perceptions Of Healthy Food Access In The Built Environment, Sharlene A. Gozalians

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Minority communities are at a higher risk for chronic diseases related to obesity because they lack access to stores that have affordable, fresh, nutritious foods that are necessary for a healthy diet. Photovoice can serve as a tool to engage youth in positive health behaviors and behavior change. Healthy food access has been analyzed based on nutrition, yet there is a lack of literature as to what factors enable and prevent access to healthy foods.

Methodology. The purpose of this study was to determine if a photovoice intervention would create a difference in perception of food access, empowerment …

The Association Of Diet With Affect, Patricia Ann Ford

Loma Linda University Electronic Theses, Dissertations & Projects

Nutrients such as omega-3 fatty acids have been associated with mental health yet few studies have examined whether foods protective or deleterious for cardiovascular disease affect mood. The purpose of this study was to examine associations between consumption of foods typical of Mediterranean and Western diets and fatty acids with positive and negative affect.

Adventist church attendees residing in North America completed a validated food frequency questionnaire in 2002-6 as part of the Adventist Health Study-2. A subset of these participants ^=9,121) completed the Positive and Negative Affect Schedule (PANAS) in the Biopsychosocial Religion and Health Study conducted in 2006-7. …

The Effect Of Non-Exercise Activity Thermogenesis On Subjects With Metabolic Syndrome, Samer Hammoudeh

Loma Linda University Electronic Theses, Dissertations & Projects

Metabolic syndrome is a cluster of metabolic abnormalities that increases the risk of cardiovascular disease and type 2 diabetes. Several criteria establish the diagnosis of metabolic syndrome, including high waist circumference, low HDL cholesterol, high triglycerides and glucose and above normal blood pressure. The prevalence of metabolic syndrome is on the rise following the rise in obesity across the globe. Qatar, a country in the Arabian Peninsula shares the burden of obesity with recent studies showing prevalences of'---61% among women and —39% among men. These studies found that metabolic syndrome is more common among women. Physical activity helps reduce visceral …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

Factors Affecting Parents Misperception Of Overweight Or Obesity In Their Children, Carol Barnes Reid

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Treating overweight children may be more difficult when parents themselves do not correctly recognize their child’s weight status (Camell, Edwards, Croker, Boniface, & Wardle, 2005 Boniface, & Wardle, 2005). While it is a commonly held belief in some cultures that overweight children are healthy, incorrectly assessing overweight in very young children results in unfavorable weight development throughout childhood (Kroje, Struthman, & Gunther, 2006). This is due to the increased likelihood that parents may not take the condition of obesity in their child as being serious, or they may fail to seek or accept professional help in correcting the problem …

Long Term Weight Variability In Adults Of Adventist Health Study 1 And 2, Namgyal Lhawang Kyulo

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The effect of overweight and obesity on the risk of fatal disease tends to attenuate with age. One plausible explanation is that a proportion of elderly people in the ideal weight category (19 to 25 kg/m ) experienced disease-related weight loss - an effect that will attenuate health risk related to overweight and obesity. One potential approach to controlling for this bias would be to examine fluctuations in weight during the adult lifespan by considering multiple measures of weight or recall of body weight during adulthood. Some of these measures are available in the Adventist Health Study cohorts and …

Civic Attitude And Activity Of Loma Linda University Dental Graduates, Gregory W. Olson

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Dentistry is regarded as a profession and granted certain privileges, such as self-regulation. Associated with this status are stated and implied responsibilities which are widely debated. In recent years, dental professionalism seems to be on the decline. Evidence cited includes access-to-care issues and decreased public trust in dentists. In response, academia and professional organizations have developed curricula and statements intended to bolster professionalism. Meanwhile little is known about practicing dentists’ attitudes or participation in health-related civic matters. Objectives: This study seeks to examine the importance Loma Linda University (LLU) dental graduates place on public roles, their reported participation in …