Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

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 …

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 …

The Role Of Ambient Air Pollution In The Occurrence Of Emphysema, Shiva Metghalchi

Loma Linda University Electronic Theses, Dissertations & Projects

Emphysema is the most common cause of death from respiratory disease in the United States. Emphysema is most common among people aged 50 and older. Those with a genetic predisposition to emphysema may experience the onset as early as their thirties or forties. Men are more likely than women to develop emphysema, but female cases are increasing as the number of female smokers rises.

In the past few years, etiological and pathogenic research has been carried out in an attempt to determine the reason for an increase in deaths and other health problems associated with air pollution, and there have …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Association Between Obesity, Depression, And Inflammation Among Seventh-Day Adventists In The Biopsychosocial Religion And Health Study, Michael Paalani

Loma Linda University Electronic Theses, Dissertations & Projects

The effects of obesity and depression on morbidity and mortality may be mediated by inflammatory processes. Homeostasis within the immune system depends on a balance of pro-inflammatory and anti-inflammatory cytokine molecules, so chronic inflammatory diseases may result from cytokine dysregulation. The target population consisted of 508 Seventh Day Adventists (SDAs) who participated in the Biopsychosocial Religion and Health Study (BHRS), a sub-study of the Adventist Health Study-2. The study was a cross-sectional analysis of the association between obesity, depression, and inflammation after controlling for demographic, socioeconomic, health behavioral, and health status variables among BHRS participants.

Obesity was assessed by body …

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, …

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, …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …

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 …

Parental Influences In Child Obesity, Janel Lynn Calinisan

Loma Linda University Electronic Theses, Dissertations & Projects

One of the greatest concerns in American society is peoples’ health. In the past several years there has been an overwhelming increase in obesity in Americans. This concern relates not only to adults, but also to children, as more are found to be overweight. Many factors have been suggested as to why more children are becoming obese, including parenting, demographics, physical activity, nutrition, and biological factors. Studies have shown that parental influence or involvement can be related to child obesity such that neglected children were more likely to be obese in adolescence and sustain it through adulthood. In order to …

Partner Communication And Factors Associated With The Decision To Obtain An Hiv Test Among Chinese/Chinese American Community College Students In Northern California, Sang Leng Trieu

Loma Linda University Electronic Theses, Dissertations & Projects

HIV testing and counseling is considered the cornerstone of a comprehensive approach to HIV prevention and education. Little is known, however, about HIV prevention, including HIV testing rates for Asian Pacific Islander (API) women, because data for this ethnic group is aggregated, thus limiting specific data for Chinese/Chinese American population or other API subgroups. This dissertation research examined factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college women and explored the association among relationship status, partnership communication, and discussions of HIV testing.

Using constructs of the health belief model, an online and paper-pencil, crosssectional …

Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo

Loma Linda University Electronic Theses, Dissertations & Projects

The study was aimed at determining if cultural beliefs are salient factors contributing to the spread of HIV/AIDS among African born adolescents aged 15 to 19 years living in southern California. We used a cross-sectional design and collected data in two phases. The first phase was qualitative and data were collected from 25 participants in focus groups. The second phase utilized a questionnaire which was developed from the results of the focus group, using the theory of planned behavior. One hundred and thirty-five black African born teenagers between the ages of 15-19 years living in southern California completed the questionnaire. …

Low Birth Weight, Very Low Birth Weight And Infant Mortality In San Bernardino County : A Secondary Analysis Of Maternal Factors, Rebecca D. Nanyonjo

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: National and state infant mortality rates have slowly declined over the last several years. Despite this reduction, San Bernardino County still has one of the highest infant mortality rates in California and racial disparities between Black and White infants not only persist but continue to widen. These disparities remain at the forefront of concern. Healthy People 2010 target objectives have yet to be reached, while national and state proposed plans have supported the statement that a community's largest health problem is initiated by its infant mortality. The purpose of this study was to investigate maternal factors through use of …

Secular Trends In Life Expectancy By Diet Status Among Never Smoking Seventh-Day Adventists, Noha Salim Daher

Loma Linda University Electronic Theses, Dissertations & Projects

To evaluate how life expectancy changed by age and secular time from 1960 through 1988, two cohort studies, the Adventist Mortality Study (AMS, 1960-1985, n = 27,530) and the Adventist Health Study (AHS, 1976-1988, n = 34,192) were combined. The life expectancy of omnivores was compared to vegetarians separately in never-smoking males and females for all-cause mortality, and where the cause of death was cardiovascular disease or all site-cancer. Life expectancies were calculated for subjects who had survived to ages 30, 50, 70, and 80 during six calendar periods: 1960- 1964, 1965-1969, 1970-1974, 1975-1979, 1980-1984, and 1985-1988. Ten-year calendar periods …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

The Role Of Meat, Poultry, And Fish Consumption In The Occurrence Of Rheumatoid And Other Forms Of Arthritis, Asnake Hailu

Loma Linda University Electronic Theses, Dissertations & Projects

Rheumatoid arthritis and other forms of arthritis or rheumatism are now the leading cause of disability in the United States. The etiology and pathogenesis are less understood and available treatment options are not always satisfactory. This dissertation measures the prevalence and cumulative incidence of rheumatoid arthritis and other forms of arthritis or rheumatism, and examines any associations with current and lifetime consumption of meat, poultry, and fish (meat) using the Adventist Health Study and the Adventist Mortality Study databases. From these databases, it was possible to reconstruct a prospective cohort, obtain self-reported information on demographic characteristics, arthritis, rheumatoid arthritis, other …

The Role Of Diet And Physical Activity For Ovarian Cancer Results From The Adventist Health Study, Fatemeh Kiani

Loma Linda University Electronic Theses, Dissertations & Projects

A few aspects of the epidemiology of ovarian cancer are well understood, such as the inverse relationship with parity and oral contraceptive (OC) use. The role of other factors such as the potential influence of diet or physical activity is far from being established. A few studies, however, have been able to identify dietary risk factors for ovarian cancer. In this dissertation, I have conducted two studies that investigate the relationship between dietary factors and physical activity and the three endpoints: 1) nonfatal ovarian cancer (1976-1982; time to diagnosis), 2) fatal ovarian cancer (1976-1988; time to death), and 3) total …

A Model For Hiv/Aids Risk Behaviors Of Students In Armenia, Talin Babikian

Loma Linda University Electronic Theses, Dissertations & Projects

Without a cure in now its third decade, AIDS is a concern for both the medical and social science disciplines. Most at risk for a nationwide AIDS epidemic are developing countries, which often lack the necessary resources and knowledge to minimize the spread of the disease. There are an estimated 1500 HIV cases in Armenia, 81.5% of which occur in the 20-39 age group. Armenia’s current economic and political instability, increase in sexually transmitted infections (STI), prostitution, and injecting drug use, and the alarming incidence rates in neighboring countries amplify its risk for a national epidemic.

The goals of this …

How Peruvian Mothers Appraise Pneumonia And The Predictors Of Their Intention To Seek Medical Care When Their Children Have Signs Of Pneumonia, César Augusto Gálvez

Loma Linda University Electronic Theses, Dissertations & Projects

Pneumonia ranks first in health problems demanding attention, and second in the cause of mortality for children under five years old in Peru (Toledo, & Minaya, 1999). Studies about behavioral determinants that influence mothers to seek medical help for their child with signs of pneumonia do not focus on the contribution of the behavioral determinants to intention of seeking medical help.

Using the Theory of Planned Behavior (TPB) and a cross-sectional design, the objectives of this study were to know first, Peruvian mothers' perceptions about knowledge and recognition of pneumonia, and about the government pneumonia campaign (GPC). Second, mothers' attitudes, …

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 …

Prevalence Of Fatty Liver In Japanese Children Ages 4 To 12 Years Old : Relationship To Obesity : An Epidemiological Ultrasonographic Survey, Kunihiko Tominaga

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of fatty liver disease in children is not well established and its relationship to childhood obesity is poorly defined. The present study of 810 northern Japanese school-aged children (4-12 years old), determined the prevalence of fatty liver and its relationship to gender and degree of obesity. Diagnosis of fatty liver was assessed by real-time ultrasonography.

RESULTS: 1. The overall prevalence of fatty liver is 2.6 %. 2. Fatty liver prevalence is higher for boys (3.4 %) than for girls (1.8 %), although not statistically significant (P = 0.15). 3. Fatty liver occurs in children as young as 6 …

Diet And Colon Cancer Risk In The Population Of Thailand, Nithat Sirichotiratana

Loma Linda University Electronic Theses, Dissertations & Projects

Epidemiological studies have emphasized environmental influences, especially a diet high in animal fat and low in fiber, as major risk factors for colon cancer. In order to examine the relationship between dietary fat and fiber and occurrence of colon cancer, patient medical records from the National Cancer Institute between 1981-1991 were used for the first hospital-based case-control study of diet and colon cancer in Thailand. These records included a total of 168 cases and 357 controls. Data on the frequency consumption of various food items were obtained by using an existing food frequency questionnaire, completed as part of patient’s history …

Case-Control Study Of Vitamin A Intake And Colorectal Cancer In Seventh-Day Adventists, John William Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Colorectal cancer is the second most common cause of cancer deaths in Americans; producing approximately 60,000 deaths in Americans each year. Studies of high and low risk populations have suggested a dietary etiology for colorectal cancer, although investigations of specific dietary factors have produced inconsistent results.

Population based studies of California Seventh-day Adventists demonstrate dietary variety regarding factors suspected as important in the etiology of colorectal cancer. These studies document a substantially reduced mortality and incidence from colorectal cancer in Seventh-day Adventists when compared to other California Populations. Although specific reasons for this difference remain obscure, the 'Unique lifestyle and …

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 …

Sero-Epidemiology Of Q Fever With Special Reference To Complications In A Hospital Population Of Southern California, Ajit Singh Randhawa

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]