Medicine and Health Sciences Commons^™

Regulation Of Pim1 Under Hypoxia In Prostate Cancer, Eva Sahakian

Loma Linda University Electronic Theses, Dissertations & Projects

A defining characteristic of solid tumors is the capacity to divide and spread under conditions of nutrient deprivation and limited oxygen availability. These microenvironmental stresses arise from structural abnormalities in tumor vessels that lead to aberrant microcirculation. Hypoxia acts as a physiological “selection pressure” in the progression of cancer by activating pathways and enhancing the expression of specific genes in tumor cells which eventually diminish their apoptotic potential. Ultimately, hypoxic microenvironment functions as a “stress factor”, selecting cells with the ability to survive and divide under anoxic conditions. The members of the PIM family of cytoplasmic serine threonine kinases are …

Immediate Tooth Replacement With Subepithelial Connective Tissue Graft Using Platform Switching Implants, Seunghwan Chung

Loma Linda University Electronic Theses, Dissertations & Projects

This case series evaluated the facial gingival stability following immediate tooth replacement in conjunction with subepithelial connective tissue graft in the esthetic zone. Implant success rate and peri-implant tissue response were also reported.

Ten patients (6 males, 4 females), with a mean age of 52.1 (range = 22.7 to 67.1) years, underwent immediate implant placement and provisionalization with SCTG and were evaluated clinically and radiographically at pre-surgery (T0), immediately after immediate tooth replacement and SCTG (T1), 3-months (T2), 6-months (T3), and 12-months (T4) after surgery. Data was analyzed using the Wilcoxon Signed-Ranks Test and Friedman Test at the significance level …

Psychometric Properties Of The Psychopathic Personality Inventory In A Non-Criminal Population, Julie Madeleine Woltil

Loma Linda University Electronic Theses, Dissertations & Projects

The Psychopathic Personality Inventory (PPI) is a self-report measure which was created to identify the personality traits of psychopathy in noncriminal populations. These personality traits were grouped into eight subscales in the PPI including Machiavellian Egocentricity, Social Potency, Coldheartedness, Carefree Nonplanfulness, Fearlessness, Blame Externalization, Impulsive Nonconformity and Stress Immunity. The hypothesized relationships and factor structure of this study follow the theory of psychopathy as being a disorder rooted in antisocial behaviors (often aggressive and impulsive in nature) and inappropriate emotional reactivity (characterized as a lack in empathy and anxiety). A confirmatory factor analysis was done with an ethnically diverse undergraduate …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

Use Of Emoticons For Assessing Emotion And Mood States In Web-Based Interventions, Jennifer Chua So

Loma Linda University Electronic Theses, Dissertations & Projects

In the rapidly growing field of online psychotherapeutic interventions, an increasing number of clinicians are seeking to extend therapeutic interventions into cyberspace. However, because communication with clients in this medium is often devoid of auditory and visual feedback, these clinicians are not able to rely on their clinical observations. It then becomes incumbent to develop a psychometrically and theoretically sound means of assessing emotion and mood states that can be easily utilized in this forum. Utilizing cross-culturally and empirically supported models of emotion structure shown to be influential in the self-report data, the Positive Affect and Negative Affect factors, this …

A Comprehensive Program Description And Recommendations For The Del Rosa Youth Program, Martin C. Hodnett

Loma Linda University Electronic Theses, Dissertations & Projects

Amid budget cuts, economic recession, and difficulties many Americans face, more families are looking for ways to access needed services and goods from nongovernmental sources. Churches and faith based organizations, such as the Del Rosa Seventh-day Adventist (SDA) Church, have been bridging the gap for families seeking assistance, particularly in the area of youth services. The Del Rosa Youth Program, an outreach program sponsored by Del Rosa SDA Church, provides mentoring and religious programming for at-risk youth. In an effort to assist them in becoming more competitive for funding, the current project has reviewed the relevant literature and provided recommendations …

Predicting Systemic Confidence, Stephanie Inez Falke

Loma Linda University Electronic Theses, Dissertations & Projects

Using a mixed method approach, this study explored which educational factors predicted systemic confidence in master’s level marital and family therapy (MFT) students, and whether or not the impact of these factors was influenced by student beliefs and their perception of their supervisor’s beliefs about the value of systemic practice. One hundred and twenty graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited (COAMFT) programs completed an online survey that assessed their training experiences, beliefs about systemic practice and perceptions of confidence. Quantitative findings revealed that students who reported greater research expectations in their program, obtained more …

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, …

Nurses' Spiritual Care Practices: Assessment, Type, Frequency, And Correlates, Iris Mamier

Loma Linda University Electronic Theses, Dissertations & Projects

This descriptive, correlational study described the type, frequency, and correlates of nurses' spiritual care practices (quantitative) and their experiences with the sacred at work (qualitative). A convenience sample of 554 (24%) of the Registered Nurses employed at a western United States faith-based tertiary care health system participated in this online survey. Nurses' spiritual care practices were assessed using the 17-item Nurses' Spiritual Care Practice Questionnaire (NSCQ). Factorial validity and reliability of the pilot NSCQ were established. Spiritual care practices most frequently endorsed were assessing patients' spiritual beliefs pertaining to health and listening to patients' stories of illness and their spiritual …

Neurodevelopmental Outcome & Mr Spectroscopy Of Therapeutic Hypothermia After Pediatric Drowning, Sharon Mieras Perugini

Loma Linda University Electronic Theses, Dissertations & Projects

Despite advances in medical treatment and technology, outcome following pediatric drowning can vary widely from mild to severe impairments and death. Prognosis is often difficult to predict given a number of contributing factors. As such, this study examined the relationship between clinical indicators including submersion duration, initial GCS and PRISM scores, and waking time with outcome as well as metabolite ratios based on magnetic resonance spectroscopy. Research stemming from the area of cardiac arrest as well as anecdotal case study reports of cold water drownings suggests that lowering the body temperature may be helpful and protective. As such, the use …

Using Cone Beam Computed Tomography To Identify A Prediction Model For Obstructive Sleep Apnea, Jodi Parker

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Obstructive Sleep Apnea (OSA) patients have increased risk of morbidity and mortality. Early diagnosis may reduce morbidity and mortality. Prediction of OSA from imaging may help to identify OSA patients earlier in life. CBCT can be used for OSA diagnostic imaging due to its three-dimensional (3D) visualization of the upper airway and craniofacial complex. Magnification associated with conventional 2D radiography is eliminated with CBCT, and radiation to the patient is significantly less than previous modalities used to measure craniofacial & airway measurements associated with OSA. During a CBCT scan, the patient's image is taken supine, rather than the upright …

Effects Of Functional Appliances On The Tmj And Mandibular Length Of Skeletal Class Ii Patients: A Cone Beam Computed Tomography Study, David C. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Functional appliances have been efficiently used in the treatment of Class II malocclusions caused by retrognathic mandibles. Cone beam computed tomography has enabled us to make more accurate linear measurements by eliminating superimposition of other structures and to analyze skeletal anatomic detail in all three planes of space. This retrospective study evaluated the osseous changes in the temporomandibular joint (TMJ) and length of the mandible in skeletal Class II malocclusion patients treated with the fixed functional appliances and compared measurements with Class I malocclusion patients treated with orthodontic mechanics that did not alter skeletal relationships.

Materials and Methods: Twelve …

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

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), …

The Influence Of Work Of Fracture On Six Orthodontic Bonding Systems, Tyler S. Pritchard

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Bonding is the primary method of attaching brackets to teeth in modem orthodontics. Thus, many studies have focused on the maximum shear bond strength values of orthodontic adhesives. In contrast, very little research has been performed considering the work of fracture of orthodontic bonding systems. Work of Fracture is defined as the area under the curve of a stress-strain graph. Previous shear bond strength studies measured the force necessary to produce bond failure. The purpose of this study was to measure the maximum shear force and displacement of six bonding systems and to calculate the work of fracture.

Materials …

Influence Of Stainless Steel Orthodontic Brackets On Magnetic Resonance Imaging, Christian James Hoybjerg

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Magnetic resonance imaging (MRI) machines provide 2D as well as 3D images that are excellent in contrasting soft-tissue in the maxillofacial region and are void of ionizing radiation. The drawbacks include the lack of depiction of cortical bony detail and image degradation caused by substances in the scanned area. Specifically, in the orthodontic field stainless steel brackets cause more distortion of MR images then any other bracket material. It is unknown what type of stainless steel alloy causes the most MRI distortion. The purpose of this study is to evaluate the degree of craniofacial MR distortion caused by various …

The Effects Of The Introduction Of An Electronic Medical Record (Emr) On Self-Reported Treatment Effects In A Psychological Service In A Family Medicine Clinic, Michael D. Herman

Loma Linda University Electronic Theses, Dissertations & Projects

The healthcare system in the United States has traditionally focused on pathogenic disease prevention and treatment of acute illness, only addressing physical health (Grzywacz & Keyes, 2004). This approach is limited, as it does not often acknowledge the influence of mental health and health promotion on outcomes. Approximately, 25-75% of all presenting cases with uncertain etiology in medicine are psychosocial or behavioral in origin (Schulte et. al., 2004). Improvements can be made through integrated care; however, divergent viewpoints and often proximity across providers disrupts, psychologist-physician communication, collaboration, and subsequently care access (McDaniel, 1995). The current study examines the self reported …

Study Of The Four Factor Theory Of Women’S Sexual Function, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual function. They suggested that unique factors need to be examined to understand sexual function in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors were described as aspects of women’s lives that can be the source of sexual dysfunction. In a previous study, Merrell (2007) utilized Tiefer et al’s (2002) four factor model of sexual functioning to examine female sexual functioning looking specifically at body shame, relationship satisfaction, positive and negative affect, sexual self-schema, and overall health. Based on the results …

Effects Of Functional Appliances On Pharyngeal Airway Dimensions: A Cone Beam Computed Tomography Study, Melissa K. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Functional appliances are intended to correct by incremental advancement of the mandible for correction of skeletal Class 11 relationships. Similar in design to functional appliances, mandibular advancing devices (MAD) are used for obstructive sleep apnea (OSA) patients as they increase the size of the airway by drawing the tongue and soft palate forwards, and thus maintain its patency during sleep. It has been shown that significant increases in airway dimensions and decreases in airway resistance were gained in OSA patients while evaluated with a MAD in place. This retrospective study evaluated volumetric, cross-sectional area and linear changes in the …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

Observer Reliability Of Cephalometric Landmark Identification On 3-D Mr Images, Michael S. Pollack

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Cephalometric analysis is a cornerstone of orthodontic diagnosis, yet much information is lost when 3-dimensional structures are assessed with 2-dimensional methods. CBCT offers 3-dimensional imaging but at the cost of higher levels of ionizing radiation. Magnetic resonance imaging provides 3-dimensional imaging without ionizing radiation and additionally imparts visualization of soft tissue structures. Prior to employing MR images for cephalometric analysis, reliability of landmark identification must be assessed. The purpose of this study was to evaluate intra- and interobserver reliability in 3-dimensional landmark identification using MR images.

Materials and Methods: Fifteen cranial MR images (3.0 T, MP-RAGE) from subjects between …

The Effect Of An Educational Intervention On The Sexual Perceptions And Practices Of Adolescents In Trinidad And Tobago, Vanessa Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) is one of the fastest spreading infectious diseases in the Caribbean, and is second only to Sub-Sahara Africa in the prevalence of HIV/AIDS cases. Trinidad and Tobago is the southernmost twin island republic in the Caribbean. In 1999, the 5^th leading cause of death among individuals ages 15-34 in Trinidad and Tobago was HIV/AIDS. According to UNAIDS (2006), the prevalence rate of HIV in Trinidad and Tobago is 2.6%.

Purpose. Currently, there is no standardized HIV/AIDS education program in secondary schools in Trinidad and Tobago. Since HIV/AIDS is …

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 …

Predicting Intention To Wean From The Bottle Among Hispanic Mothers, Elaine K. Fleming

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Hispanic children carry a disproportionate burden of prolonged bottle use and associated disease. Children in low-income households who use the bottle beyond age 12 months are at risk for iron deficiency anemia, obesity, and early childhood dental caries.

Purpose. The purpose of this study was to identify predictors of intention to wean from the bottle among low-income Hispanic mothers of infants enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC).

Method. A convenience sample of 266 low-income Hispanic mothers of infants age 5 to 14 months old were categorized into four groups by experience …

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

A Psychoeducational Group Intervention For Fibromyalgia Patients, Derek O. Bacchus

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effect of a multidisciplinary psychoeducational treatment group on Fibromyalgia Syndrome (FMS) pain, depression, catastrophizing, and quality of life. The Short-Form McGill Pain Questionnaire (SF-MPQ), Center for Epidemiologic Studies Depression Scale (CES-D), Coping Strategies Questionnaire (CSQ), and the World Health Organization Quality of Life Assessment—Abbreviated Version were used to assess these constructs in 15 participants. The sample was composed entirely of female participants and was predominantly middle aged, which is typical of the FMS population. Two separate groups of FMS patients—seven in Group 1, eight in Group 2—completed a 10-week psychoeducational intervention where they were presented with …

Postprandial Effects Of Pecans Ingestion On Plasma Level Of Nutrients, Polyphenolic Compounds And Biomarkers Of Antioxidant Status In Human Volunteers, Chatrapa Hudthagosol

Loma Linda University Electronic Theses, Dissertations & Projects

Pecans (Carya illinoinensis) are rich sources of polyphenolic compounds and nutrients, which have antioxidant capacity results in favorable reductions in plasma lipids and lipoproteins. However, the health benefits of pecans may not be limited to blood lipid changes. There has been very little investigation into the contribution of bioactive components found in nuts to antioxidant protection. The purposes of the study were 1) to determine the impact of pecan consumption on concentration of total plasma polyphenols and their peak concentration over time. 2) to measure the effect of a pecan diet on postprandial levels of plasma lipid peroxidation …

Mnte-2-Pyp And Radiation In A Prostate Cancer Model: Implications For Radiotherapy, Adeola Y. Makinde

Loma Linda University Electronic Theses, Dissertations & Projects

A major limitation of successful radiation therapy in cancer treatment is the increase in normal tissue damage as higher doses are used to achieve greater tumor destruction. Radiation dose optimization in cancer therapy requires achieving maximum tumor destruction with minimal damage to normal tissue Antioxidants have been shown to protect normal tissues against radiation damage, as radiation-induced tissue damage results predominantly from reactive oxygen species that directly damage cellular components. However, for effective use as normal tissue radioprotectants in radiotherapy, these antioxidants must not protect the tumors. Mn (III) tetrakis (N-ethylpyridinium-2-yl) porphyrin (MnTE-2-PyP) is a metalloporphyrin antioxidant that has been …

Creating The Patient-Doctor-Family Relationship: Issues Of Power And Gender, Josephine M. M. Perez

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: To understand how patients, doctors, and families see, form, and commit to relationship and how power and gender influence their interpersonal processes and meanings.

Methods: Grounded theory methodology was used. There were six family medicine physicians, ten patients, and ten family members who participated. Physicians, patients, and family members were matched.

Results: Four themes emerged: types of patient-doctor-family relationships (extended family and traditional), types of care (relationship-centered care (RCC), family-oriented care (FOC), whole-person care (WPC), and patient-centered care (PCC)), commitment and intimacy, and interpersonal processes (perception of relationship shape, bonding, confidence and trust, equality and partnership, mutuality, …