Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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, …

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 …

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 …

Development And Formative Implementation Of A Nutrition Assessment And Peer Education Program Based On Dietary Analysis At A California State University, Janay Jelso

Master's Theses

A healthy diet has been established as a key component contributing to an individual’s quality of life. Statistics show that the diet of Americans needs improvement (Guenther et al., 2007) indicating possible lack knowledge of what healthy eating behaviors are. There is an abundance of nutrition misinformation available to the consumer (American Dietetic Association, 2002a). Dietary interventions that provide credible education based on readiness to change behaviors and goal setting have been successful in increasing awareness of what healthy eating behaviors are and changing existing behaviors over time (Ammerman et al., 2002; Evans & Sawyer-Morse, 2002; Gambera et al., 1995; …

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 …

Exploring The Stress Response In New Army Nurses, Laureen Otto

Theses and Dissertations

The study of stress is limited in professional nursing, but it is nearly non-existent in professional military nursing. The purpose of this study was to explore the relationships among psychological, environmental, biological and demographic factors of stress in new Army nurses during the Army Medical Department’s 8-week Officer Basic Leadership Course (OBLC). Using a descriptive prospective, correlational repeated measures design, 33 study participants completed two psychological stress measures (Perceived Stress Scale [PSS] and the Impact of Event Scale – Revised[IES-R]), an environmental measure (Life Experiences Survey [LES]), a biologic measure (salivary cortisol) and a demographic questionnaire at three different time …

A Comparative Study Of The Genotype Mtbdrplus® Assay Against A Standard Culture Method For Diagnosis And Drug Susceptibility Testing Of Tuberculosis, Peris W. Thamaini

Master of Medicine in Clinical Pathology

Background: Nearly one-third of the global population, i.e. two billion people, is infected with Mycobacterium tuberculosis and is at risk of developing the disease. More than eight million people develop active tuberculosis (TB) every year, with about two million dying from the disease annually. Diagnosis of tuberculosis inKenya remains dependent on smear microscopy. New methods of TB diagnosis are needed which have better accuracy and are still cost effective. Molecular methods of TB diagnosis have come under investigation in a lot of studies recently. However, they have their own limitations including the inability to differentiate between active organisms and dead …

Risk Of Contrast Induced Nephropathy In Hiv Patients Receiving Radiographic Contrast At Three Aga Khan Hospitals, Sitna A. Mwanzi

Master of Medicine in Internal Medicine

Aim: To study the influence of HIV infection on the development of contrast induced nephropathy in patients receiving radio contrast material Design: Prospective cohort study Patients and setting:One hundred and twenty five (125) HIV positive patients and one hundred and fifty five (155) HIV negative patients selected from in and out patient departments of the Aga Khan University Hospital, Nairobi and Aga Khan Hospitals in Mombasa and Kisumu, were evaluated for the study between August 2008 and August 2009. Methodology: Eligible patients undergoing radiological evaluation requiring the use of radio contrast material were consecutively recruited for the study after which …

The Development And Evaluation Of Low-Load Resistance Exercise With Blood Flow Restriction As A Countermeasure To Muscular Unloading, Summer B. Cook

Dissertations - ALL

Future space exploration must overcome both scientific and non-scientific obstacles. In accordance with the mission statement of the National Aeronautics Space Administration (NASA) (described in Chapter I), there were four major aims of these experiments. The first was to develop an exercise countermeasure to prevent muscle atrophy and weakness during simulated microgravity. The second and third aims were to determine the physiological adaptations in the knee extensor muscles and plantar flexor muscles following prolonged unloading in human subjects and to assess the effectiveness of the exercise countermeasure at preventing disuse atrophy. The final aim was to assess the relationship between …

The Effects Of Interx Therapy And Tens On Pain Relief In Patients Suffering From Medial Tibial Stress Syndrome, John Robert Erwin

Student Theses and Dissertations

One common injury throughout athletics involving running, is medial tibial stress syndrome (MTSS). In athletic training, electrical stimulation is used for control of pain associated with orthopedic injury. The purpose of this study is to compare the effect of InterX electrotherapy and Transcutaneous Electrical Nerve Stimulation's (TENS) ability to aid in the relief of pain from MTSS during running. Fourteen athletes with a current history of MTSS participated. A 2 minute warm up to reach an RPE score of 12 occurred first. Upon completion, the electrical stimulation was applied while the subject exercised at an RPE of 12 for 10 …

Identification Of Clinical, Laboratory And Genetic Covariates For Pharmacokinetics, Efficacy And Toxicity Of Sorafenib In Patients With Solid Tumors, Lokesh Jain

Theses and Dissertations

The goal of this research work was to understand the clinical-pharmacology based treatment approaches for sorafenib. Treatment with sorafenib is associated with high inter-patient variability in pharmacokinetic exposures, efficacy and toxicity. We explored the demographic, laboratory, clinical and pharmacogenetic factors to elucidate the sources of variability. In addition, we examined the impact of pharmacogenetic variation in VEGFR2, an important mediator of the VEGF pathway, on risk of prostate cancer. To support these investigations, (mainly single-dose) pharmacokinetic, pharmacogenetic, efficacy and toxicity information were collected from patients with solid tumors, enrolled in five phase I / II clinical trials at National Cancer …

Automated Identification Of Noun Clauses In Clinical Language Samples, Britney Richey Manning

Theses and Dissertations

The identification of complex grammatical structures including noun clauses is of clinical importance because differences in the use of these structures have been found between individuals with and without language impairment. In recent years, computer software has been used to assist in analyzing clinical language samples. However, this software has been unable to accurately identify complex syntactic structures such as noun clauses. The present study investigated the accuracy of new software, called Cx, in identifying finite wh- and that-noun clauses. Two sets of language samples were used. One set included 10 children with language impairment, 10 age-matched peers, …

Development Of Psychometrically Equivalent Speech Audiometry Materials For Testing Children In Mongolian, Meghan Elizabeth Caldwell

Theses and Dissertations

The purpose of this study was to develop, digitally record, evaluate, and equate Mongolian monosyllabic and bisyllabic child-appropriate words which can be used in the measurement of word recognition scores and speech-reception threshold (SRT) in children who are native speakers of Mongolian. Based on data collected from a survey of Mongolian child language professionals, a subset of child-appropriate materials was adapted from a set of materials developed for Mongolian adults. Two lists of 50 monosyllabic words and four half-lists of 25 words each were developed for testing the word recognition abilities of Mongolian children. The developed lists and half-lists were …

Patterns Of Vowel Production In Speakers Of American English From The State Of Utah, Larkin Hopkins Reeves

Theses and Dissertations

The English spoken in the United States has traditionally been divided into six dialect regions: New England, Mid-Atlantic, Southern, Midland, Northern, and Western. The acoustic properties of American English spoken in the Southern and Northern dialect regions have been the subject of intense research, but the acoustic properties of the Western dialect region have not been analyzed as thoroughly. The umbrella term, Western American English, includes the English spoken in a large geographic area that stretches from Montana, Wyoming, Colorado, and New Mexico to the Pacific coast. Research that has focused on the Western dialect has included participants from several …

The Withdrawn And Sociable Behaviors Of Children With Specific And Nonspecific Language Impairment, Heather Haskin

Theses and Dissertations

Recently researchers have identified a group of children with language impairment (LI) whose IQ scores are below the typical IQ cutoff of 85 for specific language impairment (SLI) but above the IQ cutoff of 70 for intellectual disability (Weismer et al., 2000). This group is referred to as having nonspecific language impairment (NLI). Eleven children with NLI, eleven same-age peers with SLI, and eleven same-age typical peers were compared on withdrawn and sociable behaviors demonstrated in the classroom setting using the Teacher Behavior Rating Scale (Hart & Robinson, 1996). Three subtypes of withdrawal (solitary-active, solitary-passive, reticent) and two subtypes of …

Median Values For Second-Trimester Maternal Serum Αlpha Fetoprotein And Human Chorionic Gonadotrophin (Double Test) At Aga Khan University Hospital-Nairobi, Nancy A. Okinda

Master of Medicine in Clinical Pathology

Aim To establish median values for second trimester maternal serum human chorionic gonadotrophin (HCG) and alpha fetoprotein (AFP) at Aga Khan University Hospital- Nairobi (AKUH-N) using the Abbott Micro particle Enzyme immunoassay. Specific objectives •To perform measurements of second trimester maternal serum human chorionic gonadotrophin (HCG) and alpha fetoprotein (AFP) and to establish observed and regressed median values. •To establish regression coefficients for regressed medians of AFP and HCG. •To compare these data with data obtained from other geographical regions. Methodology 330 serum samples from women of gestational ages 15 to 20 weeks were analyzed for AFP and HCG. Observed …

Perceptions Among Students In Online Health Related Courses - A Pilot Study, Kathy Sullivan

Master's Projects

Given the proliferation of online courses in university education, continuous evaluation is imperative to ensure quality. This study utilized a quantitative descriptive design using a questionnaire to explore the perceived adequacy and acceptance of distance learning in undergraduate health related courses. Questions were designed to elicit students' reactions to teaching methods, course content, and how the format influenced their learning. Overall, acceptance of online courses is high. Most of the students were willing to take another online course in the future. Respondents felt that online courses offer more flexibility, encourage both independent and critical thinking skills, and that the course …

Use Of Magnetic Resonance Spectroscopy (Mrs) To Improve Magnetic Resonance Imaging (Mri) In The Diagnosis Of Intracranial Pathology, Done At Aga Khan University, Joyce Sande

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Magnetic Resonance Spectroscopy (MRS)is a potentially useful adjunct to Magnetic Resonance Imaging (MRI) in thecharacterization of focal brain lesions. This study was aimed at showing that by the additional use of MRS (MRI, MRS), the characterization of a focal brain lesion into neoplastic, or non- neoplastic (infective, or degenerative) can be improved, as compared to the use of MRI alone. Study question: Does the additional use of MRS improve MRI differentiation of neoplastic from non- neoplastic (infective or degenerative) focal brain lesions? Methods: The design was prospective, analytical and comparative. 80 consecutive patients were enrolled. Conventional MRI of the …

Adenosine Dimethyltransferase Ksga: Biochemical Characterization Of The Protein And Its Interaction With The 30s Subunit, Pooja Desai

Theses and Dissertations

Ribosomes form the core of the protein biosynthesis machinery and are essential to life. Ribosome biogenesis is a complex cellular process involving transcription of rRNA, pre-rRNA processing, rRNA modification and simultaneous assembly of ribosomal proteins. RNA nucleotide modification is observed in all domains of life. While there is enormous conservation of ribosome structure, very few post-transcriptional rRNA modifications have been conserved throughout evolution. A notable example of such rare conservation is the dimethylation of two adjacent adenosines in the 3’-terminal helix, a highly conserved region of the small subunit rRNA. Enzymes that carry out these dimethylations are equally conserved and …

Evaluating The Diagnostic Performance Of An Initial Transvaginal Sonogram (Tvs) In Patients With Suspected Ectopic Pregnancy, Zablon Bett

Master of Medicine in Imaging and Diagnostic Radiology

Purpose of the study: To evaluate the diagnostic performance of an initial transvaginal sonogram (TVS) in patients with suspected ectopic pregnancy (EP). Objectives: 1) To determine the accuracy, sensitivity, specificity, positive and negative predictive values of an initial TVS scan in patients with suspected EP. 2) To determine the diagnostic utility of TVS findings as predictors of EP. Methodology: This was a descriptive, prospective study of 131 consecutive mothers who had TVS for clinical suspicion of EP at the Aga Khan University hospital over a 12 month period between November 2007 and October 2008. The scans were performed in our …

Mutagenesis And Spectroscopic Studies Of Mycobacterium Tuberculosis Sterol 14alpha Demethylase., Anuja R. Modi

Theses and Dissertations

P450s are heme containing enzymes which affect oxidation of substrates via catalytic intermediates having transient lifetimes. These oxidative catalytic intermediates are formed by a sequential interplay of electrons and protons at the active site of the enzyme bearing molecular dioxygen. The proton transfer to the active site from bulk solvent is coordinated by an “acid-alcohol” pair of active site residues which are conserved in all P450s. Sterol 14α-demethylases (CYP51) are P450 enzymes which catalyze oxidative deformylation of lanosterol in the cholesterol/ergosterol biosynthetic pathway. Both cholesterol and ergosterol are important regulators of membrane fluidity. CYP51 differs from other P450s in that …

Examining The Relationships Between Parental Efficacy, Parenting Styles And Repetitive Behaviors In Children With Autism, James R. Carrillo

Graduate Theses

The purpose of this study was to examine the relationships between parental efficacy, parenting styles and stereotypical behaviors exhibited by children with autism. Fourteen mothers and their children with autism (ages 14-21) were recruited from local schools and the rehabilitation center. Surveys used in this study included the Repetitive Behavior Scale-Revised (RBS-R), Parents Sense of Competence (PSOC) and the Parents Locus of Control (PLOC) scale. Also incorporated was the Autism Diagnostic Observation Schedule (ADOS). Even though there was no correlation between the PLOC and stereotypical behaviors of the RBS-R, results revealed a significant relationship between the PSOC and the RBS-R. …

Knowledge, Attitudes, And Job Satisfaction In Long-Term Care: A Comparison Between Licensed Nurses And Nursing Assistants, Lynne Almand

Graduate Theses

Knowledge, attitudes, and job satisfaction of long-term care workers were examined to determine if a relationship existed between these factors and if differences existed between licensed nurses and nursing assistants. Participants included 36 nurses and 60 assistants from five nursing homes in the Midland/Odessa area. Results indicated that nurses had significantly more positive attitudes toward (t(94) = -5.72, p<.05) and increased knowledge of older adults (t(94) = 2.71, p<.05) than assistants. In addition, more positive attitudes were significantly associated with more knowledge of the elderly (r(96) = -0.36, p<.05) as well as increased levels of job satisfaction (r(96) = -0.53, p<.05).

A Longitudinal Study Of Fetal Tissue Transplantation Surgery: The Effects On Quality Of Life And Personality For Individuals With Parkinson's Disease, Cynthia C. Cole

Electronic Theses and Dissertations

Parkinson's disease (PD) is a chronic and progressive condition that affects the physical, emotional, and social functioning of individuals. Freed et al. (2001) conducted a double-blind sham-controlled trial to investigate the effectiveness of fetal tissue transplantation of those with PD. The authors investigated the effects of the surgery across the dimensions of physical and neurological functioning. A quality of life (QoL) study was conducted to determine if there were differences in QoL when comparing those who received the fetal tissue transplantation to those who received the sham surgery (McRae et al., 2004).

While there is little research on the effectiveness …

Attitudes Toward Psychotropic Medications Among Psychotropic Medications Among Psychiatric Outpatients And The General Population, Stephanie A. Fife

Graduate Theses

Attitudes and beliefs towards psychotropic medication were evaluated among psychiatric outpatients, patients seeking buprenorphine for substance abuse, and nonusers in a general population. The Drug Attitude Inventory scale (DAI-10) and the Beliefs about Medicines Questionnaire General (BMQ-G) were used to assess attitudes and beliefs of 49 participants. The general population had a negative attitude toward psychotropic medication and the psychiatric groups showed positive attitudes. Compliance and noncompliance were not associated with attitudes or beliefs toward psychotropic medication. Other findings include that females had less positive attitudes and beliefs towards psychotropic medication than males. The current findings expand and support research …

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 …