Medicine and Health Sciences Commons^™

Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert

Loma Linda University Electronic Theses, Dissertations & Projects

A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.

Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …

The Effect Of Stress And Genetic Factors On Alcohol Consumption Among Males In Olancho District, Honduras, Gloria Amanda Madrid

Loma Linda University Electronic Theses, Dissertations & Projects

Alcoholism is a major public health problem globally. More than twenty studies have examined the association between the neurotransmitter dopamine DRD2 TaqI polymorphism and the onset of alcoholism, with half supporting an association. This study was based on the assumption that there is a relationship between the presence of the DRD2, one’s exposure to stress, and alcohol consumption. We examined the gene-stress interactional model in a sample of 309 males of Mayan descendents in the Olancho district of Honduras (age range 18-87). Participants were interviewed by a health care professional and blood samples were obtained for genetic identification. The Michigan …

Predicting Milk And Soft Drink Consumption Among Female Adolescents Using The Theory Of Planned Behavior, Nada Osman Kassem

Loma Linda University Electronic Theses, Dissertations & Projects

A total of 756 female adolescents, aged 13 to 18 years, from five public high schools in Antelope Valley Union High School District located in North Los Angeles County participated in this study between February 1999 and March 1999. The ethnic composition was 53.3% White/Anglo Americans, 19.3% Hispanics or Latinos and 10.2% Black/African Americans. The constructs of the Theory of Planned Behavior (attitude, subjective norm, and perceived behavioral control and their underlying beliefs) were assessed to determine the predictors of low-fat milk and regular soda consumption. A cross-sectional design with group-administered questionnaires was utilized.

Most participants (89.6%, n = 636) …

Risk Factors Associated With Infant Mortality Among Very Low Birthweight Infants Of Teenage Mothers In San Bernardino County, C. Letitia Henry

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Typically, infant mortality decreases as maternal age increases in teenagers. In contrast to these national data, San Bernardino County (SBC) experienced a different phenomenon in 1989-1994 among very low birthweight (VLBW) infants. The infant mortality rate (IMR) of VLBW infants born to mothers under 17 years old (283 per 1000 live births) was significantly lower than the IMR of VLBW infants born to mothers between the ages of 17-19 years old (430 per 1000 live births) (p = .02).

Purpose. The purpose of the study was to explain the discrepancy between IMRs of VLBW infants of younger teenage mothers …

The Role Of Brn-3.2 In Retinal Ganglion Cell Differentiation, Jerin Marie Wright

Loma Linda University Electronic Theses, Dissertations & Projects

Within the retina, the POU domain of transcription factors brn-3.0, brn-3.1, and brn-3.2 are present only in retinal ganglion cells. These genes are believed to be involved in establishing neural cell lineages in mammals. In this study brn-3.2 was examined by comparing the number of ganglion cells present during postnatal development in normal mice (+/+), in mice homozygous (-/-) for the brn-3.2 gene, and in adult mice with a heterozygous gene deletion (+/-) for brn-3.2. Optic nerve cross sections were imaged by electron microscopy, and axon profiles counted systematically by hand. These counts were then related to the nerve cross …

A Preclinical Model Of Ionizing Radiation And Tnf-Alpha Gene Therapy For Cancer, Jun Li

Loma Linda University Electronic Theses, Dissertations & Projects

Long term control of high-grade brain tumors is rarely achieved with current therapeutic regimens. This study sought to determine if pretreatment with plasmid DNA expressing Tumor Necrosis Factor-α (TNF-α) could enhance the effect of ionizing radiation in an aggressive, rapidly growing glioma tumor (C6) model. Plasmid DNA is an attractive vector system for delivery of foreign genes into eukaryotic cells due to its advantages including low immunogenicity in vivo, lesser toxicity and relatively low cost. We have constructed a plasmid-based mammalian expression vector (pGL1-TNF) to secrete human TNF-α from cancer cells. Plasmid DNA was successfully transfected into C6 cells …

Family And Child Psychosocial Functioning Of Infant Heart Transplant Recipients, Kimberly R. Freeman

Loma Linda University Electronic Theses, Dissertations & Projects

With the advancement of medical procedures, heart transplantation has become a viable alternative for infants born with congenital or acquired heart disease. Although these children are thought to experience much improvement in their overall physical functioning post-transplantation, the long-term psychological functioning of these children and their families is currently unknown. This study examines the long-term family functioning and psychosocial development of infant heart transplant recipients in comparison to children with congenital heart disease (CHD) and non-clinical control children. Results indicate that infant heart transplant recipients and their families experience fewer overall problems as compared to the CHD group, and more …

Various Presentation Styles For Informing Parents About Pediatric Dental Procedures, Tracy Dean Walker

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The treatment of pediatric dental patients can only be as effective as the degree to which the parent consents to treatment. This study was designed to A) determine the most effective method of communicating a dental procedure to the parent of a pediatric patient and B) determine the impact that various presentation methods would have on a parent's willingness to give informed consent.

Methods: A Pulpotomy procedure was explained to each parent by one of the following methods; 1) written, 2) written and model, 3) verbal or 4) verbal and model.

Results: A statistically significant relationship was shown between …

The Effect Of Mandibular First Molar Tip Back On Mandibular Incisor Long-Term Stability, Barton L. Soper

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to determine if mandibular first molar distal tip back during orthodontic treatment will result in improved long-term alignment of mandibular incisors. Our pre and posttreatment sample consisted of 57 Class I and Class II patients (40 female and 17 male). Incisor irregularity was recorded at T2 and T4 (average of 12.9 years postretention at T4). Molar tipback was evaluated T1 to T2 and T2 to T4. The sample was divided into 3 groups - molars tipped distally 1 degree or more during treatment, molars essentially not tipped, and molars tipped mesially 1 degree or …

Clinical Debonding Simulation Study Of One Metal And Two Ceramic Brackets, Hyunsup Shim

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to compare two mechanical debonding methods on ceramic brackets (TP MXi and 3M Clarity) and a metal bracket (GAC OmniArch) with four different bonding materials (light-cured, one-step chemical-cured, two-step chemical-cured, and Fuji GIC) in clinical simulation, where the diametral force was applied on the handle of the pliers. The effectiveness of mechanical debonding technique was determined by evaluating the following variables: the amount of force required to debond the bracket, the amount of residual adhesive remaining on the enamel surface, the frequency of unexpected bracket failure, and the prevalence of visible enamel damage. The …

Neuronal And Metabolic Increases In Pedunculopontine Nucleus Of Parkinson's Rats, Jonathan Dennis Carlson

Loma Linda University Electronic Theses, Dissertations & Projects

The theoretical mechanisms underlying the symptoms of Parkinson’s disease are based on dysfunctional output from the basal ganglia projected to the cortex via the thalamus. However, the subthalamic nucleus (STN) and substantia nigra pars reticularis (SNr) as part of the basal ganglia, also project to the brainstem, in particular to the pedunculopontine nucleus (PPN). Both the STN and SNr have altered neuronal activity in the 6-hydroxydopamine (6-OHDA) Parkinson’s model rat. Thus, it is hypothesized that the PPN is altered in this model of Parkinson’s disease.

This hypothesis was examined by comparing the rates of glucose metabolism and spontaneous neuronal activity …

Regulation Of Connexin43 By Phosphorylation, Maithili M. Shah

Loma Linda University Electronic Theses, Dissertations & Projects

Gap junctions play a crucial role in embryogenesis, especially of the heart where connexin43 is thought to be important for its formation as well as synchronized contraction. Several reports have shown that connexin43 protein is phosphorylated on serine residues in vitro and in vivo.

Studies performed in our laboratory have demonstrated that cell-to-cell communication in cells expressing connexin43 can be controlled rapidly and reversibly by microinjection of active protein kinases or phosphatases that target serine or threonine residues. Phosphorylation by cAMP-dependent protein kinase (PKA) seems to favor channel opening, whereas the effect of protein kinase C (PKC) on channel gating …

Predicting Aggression And Stress In Law Enforcement Using The Mmpi : A Vulnerability Hypothesis, Byron Earle Greenberg

Loma Linda University Electronic Theses, Dissertations & Projects

This study addresses the use of scales and subscales from prehire MMPI’s to predict levels of aggression and stress among law enforcement professionals in the field (n=75). Multiple regression analysis revealed promising results in support of the MMPI’s predictive utility.

Two scales, Aggression (AGR) and Stress Vulnerability (SYS) were developed as outcome measures through a three step validation process: (a) theoretical-substantive, through a literature review and analysis of pilot data (n = 202); (b) internal-structural, statistical analysis on sample data and (c) criterion-external, through corelational analysis with externally derived departmental assessments of each officer. The final Aggression index (AGR) is …

Recidivism Among Jamaican Teenage Mothers : A Historical Cohort Study 1995-1998, Vonna Lou Caleb Drayton

Loma Linda University Electronic Theses, Dissertations & Projects

Pregnancy is the single most important reason why girls fail to complete secondary school in the Caribbean. The Women's Centre of Jamaica Foundation (WCJF) Program was established in 1978 to enable adolescent mothers 16 years and under to return to school, and to delay second pregnancies until completion of their education.

This historical cohort study assessed the effect of the WCJF Program on the incidence of repeat pregnancies over the period 1995-1998, and on the educational attainment of program participants. A random sample (n=260) of primiparous Jamaican adolescent mothers 12-16 years who gave birth in 1994 in the parishes of …

Patient Participation In Physical Therapy Goal-Setting, Susan M. Baker

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. An important part of treatment planning in physical therapy is effective goal-setting. The Guide to Physical Therapist Practice recommends that therapists identify the patient’s goals and objectives during the initial evaluation as a way to maximize treatment outcomes. The purpose of this study was to examine whether therapists seek patient participation in goal-setting and, if so, with what methods. We also examined therapists’ attitudes toward participation and patient satisfaction with the evaluation encounter.

Subjects and Methods. Twenty-two physical therapists audiotaped the initial evaluation of 73 elder patients. The audiotaped evaluations were then scored using the Participation …

Effect Of Obturation And / Or Coronal Seal On The Success Of Root Canal Therapy : An In Vivo Histologic Investigation, Douglas Snider

Loma Linda University Electronic Theses, Dissertations & Projects

Numerous studies have examined coronal leakage with in vitro protocols. A search of the literature showed the absence of a long term in vivo, histologic study, examining the effect of coronal and/or radicular leakage on periradicular health.

The purpose of this study was to evaluate the effect of obturation and / or coronal seal in preventing the formation of periradicular lesions in dogs over time. The study was conducted on six beagle dogs. Premolars were cleaned and shaped. Sixteen roots in each dog were randomly assigned to one of four treatment groups of equal size. Group one was obturated using …

Antitumor Effect Of Il-2, P53, And Bax Naked Gene Transfer In C6 Glioma Cells, Peyman Haghighat

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract not included]

The Immunology Of Parturition, Ari Mayer Mackler

Loma Linda University Electronic Theses, Dissertations & Projects

Macrophage-derived factors have been implicated in the etiology of preterm labor but little is known about trafficking of this immune cell into the uterus or its regulation of uterine contractility in mice. Enhanced number and activation of macrophages was hypothesized to precede parturition. Studies characterized contractile activity and the distribution of macrophages in the uterus of C3/HeN mice before and after term (=day 19). Contractile activity by uterine strips on days 15 and 18 of pregnancy, the day of delivery, and 1 day postpartum indicate that an endogenous oscillator sustains high frequency contractions. Modest acceleration of the pacemaker occurred before …

Diagnosis And Treatment Of Swallowing Dysfunctions : Semg Cognitive Training As An Adjunct To Conventional Therapy, Vicky T. Nguyen

Loma Linda University Electronic Theses, Dissertations & Projects

This study compared surface electromyography (sEMG) cognitive training to conventional myofunctional therapy in controlling a swallowing dysfunction, commonly referred to as "tongue thrust". Nasal airway resistance (NAR) was assessed on every subject, to rule out mechanical obstruction that would prevent proper function. The scope of this investigation composed of evaluating baseline activity and dry swallowing patterns. Subjects were distributed to one of three treatment groups: sEMG cognitive training, conventional myofunctional therapy, and control, based on the degree of NAR (normal, mild, or moderate). Initial sEMG recordings were then taken on subjects that clinically demonstrated a tongue thrust habit to confirm …

The Validation Of An Existing Sleep Apnea Questionnaire And Its Application To Clinical Orthodontics, Jeffery C. Biggs

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to validate a sleep apnea questionnaire from the Loma Linda University Sleep Disorders Center, and then to utilize the questionnaire in order to identify potential sleep apnea patients from a pre-orthodontic patient sample. Study patients were selected from the Loma Linda University Sleep Disorders Center and the Loma Linda University Orthodontics Clinic, both in Loma Linda, California, USA.

Methods: The study sample represented all of the patients initially examined from 1996 through 1998 who were age 8-15 years old at the time of the initial exam. Validation of the questionnaire was based on responses …

Dna-Dna Checkerboard Hybridization To Identify Bacteria In Human Plaque Samples, Jasan Lee Zimmerman

Loma Linda University Electronic Theses, Dissertations & Projects

Previous research has shown that using DNA probes to identify the presence of specific bacteria in human plaque samples is superior to the commonly used anaerobic cultural procedures. Some periodontal pathogens are either uncultivable or very difficult to grow, such as Prevotella intermedia, P. nigrescens, and Eubacterium brachy. Digoxygenin probes were prepared for 15 oral bacteria. These probes were used with a checkerboard DNA-DNA hybridization scheme to analyze whether human plaque samples contained any of the 15 bacterial species. Our results have shown that this method is successful in identifying bacterial DNA present in the subgingival patient plaque …

Evaluation Of The Effects Of Heat Treatment Using Orthotherm On Thermally Activated Archwires, Brent J. Hurst

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the effects of heat treatment on thermally activated nickel titanium archwires, and to determine the differences between wires from individual manufacturers. Thermally activated, nickel titanium wires were obtained from five different manufacturers in the 0.016 x 0.022 format. All wires were measured with a micrometer to determine their exact dimensions. Half of the wires were heat treated with the use of the Orthotherm Bending Art Programmer from Syrinx Medical Technologies (Berlin, Germany) while the other half served as a control. By passing an electrical current through the wires for a predetermined period …

Marginal Discrepancy Of Components Utilized For Implant Framework Construction, Mathew Thomas Kattadiyil

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated marginal fit discrepancy of the abutment-implant body interface employing various components commonly utilized for implant framework fabrication. Four types of components ( castable plastic patterns, premachined gold abutments, premachined titanium abutments and CAD-CAM custom premachined titanium abutments) were evaluated. Five castable plastic patterns and five premachined gold abutme~ts from each of two manufacturers, five premachined titanium abutments and five CAD-CAM custom premachined titanium abutments were used. Components were affixed to a 3.75 x 10 mm dental implant and standardized measurements were obtained of the abutment-implant interface using a computerassisted microscope at various experimental time intervals. Measurements of …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

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 …

The Role Of Gap Junctions In Congenital Diseases Of The Heart, Scott Henry Britz-Cunningham

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Gap junctions are thought to have a crucial role in the synchronized contraction of the heart and in embryonic development. Connexin43, the major protein of gap junctions in the heart, is targeted by several protein kinases that regulate myocardial cell-cell coupling. We hypothesized that mutations altering sites critical to this regulation would lead to functional or developmental abnormalities of the heart.

Methods. Connexin43 DNA from 25 normal subjects and 30 children with a variety of congenital heart diseases was amplified by the polymerase chain reaction and sequenced. Mutant DNA was expressed in cell culture and examined for its effect …

A Cross-Sectional Study Examining Lifestyle And Rheumatoid Arthritis, Leslie Nazaroff

Loma Linda University Electronic Theses, Dissertations & Projects

Objective. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA affects 0.5-2% of the population. Though it is predominantly a progressive disease, adjunct therapy may slow the destructive pathway or alleviate affiliated symptoms. This study examined the effects of lifestyle (diet and exercise) and self-efficacy on symptoms of RA as measured by disease activity and health satisfaction.

Methods. Seventy-five RA patients (77% female) from the Loma Linda University Faculty Medical Offices, Rheumatology Department completed self-assessment surveys on their lifestyle practices and RA affliction. Disease symptoms and activity were assessed with the Arthritis Impact Measurement …

Regulation Of Connexin43 By Phosphorylation In Heart Development, John C. Duncan

Loma Linda University Electronic Theses, Dissertations & Projects

Serine/threonine protein kinases have been shown to reversibly regulate cell-cell communication through gap junctions formed by connexin 43 (Cx43) (Godwin et al.7 1993). The Cx43 protein expression levels are unclear and what role phosphorylation plays in the regulation of signal transduction through these gap junctions during heart formation. Reportedly, mutations which replace potentially phosphorylatable serines within the Cx43 protein are associated with heart malformations (Britz-Cunningham et al.. 1995), highlighting the importance of determining the levels of Cx43 and the activities of PKA and PKC during heart development.

Western analysis performed on hearts from developmentally significant time points revealed principally high …

A Comparison Of Bond Strength Between Three Glass Ionomer Cements Used For The Retention Of Orthodontic Bands, Bryan C. Johnson

Loma Linda University Electronic Theses, Dissertations & Projects

The study compared the retentive bond strength of Ketac-Cem with Ultra Bond-Lok and a 3M Experimental glass ionomer cement at 1 hour and 24 hours using laser and common light cure techniques. The sample consisted of one hundred twenty sound extracted human molars divided into 5 groups: Ketac-Cem (self-cure), Ultra Band-Lok (light-cure), Ultra Band-Lok (laser cure), 3M Experimental (light-cure) and 3M Experimental (laser cure). Stainless steel orthodontic bands with buccal and lingual cleats were cemented as per manufacturer's instructions for each of the test samples. The samples were placed in water until ready for testing. The shear bond strength of …

Establishing Norms For A Mexican Group Using Ricketts, Steiner And Arnett Analyses, Mauricio Gonzalez Balut

Loma Linda University Electronic Theses, Dissertations & Projects

Most existing cephalometric analyses are based on norms for the Caucasian population. Therefore, they cannot be properly applied for Mexican or Hispanic patients. Ethnic variations in the normal positions of the maxilla and mandible influence and alter the diagnosis and treatment plan for each of the different type of malocclusions. Previous studies have addressed the difference between the Caucasian norms and the Hispanic norms, this indicates the variety of their skeletal, dental and facial features.

It is the purpose of this study to establish specific cephalometric standards for the native Mexican group, using the Steiner and Ricketts analyses along with …