Medicine and Health Sciences Commons^™

Prevalence Of Obesity, Type Ii Diabetes Mellitus, Hyperlipidemia, And Hypertension In The United States: Findings From The Ge Centricity Electronic Medical Record Database., Albert G Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette

College of Population Health Faculty Papers

This study analyzed GE Centricity Electronic Medical Record (EMR) data to examine the effects of body mass index (BMI) and obesity, key risk factor components of metabolic syndrome, on the prevalence of 3 chronic diseases: type II diabetes mellitus, hyperlipidemia, and hypertension. These chronic diseases occur with high prevalence and impose high disease burdens. The rationale for using Centricity EMR data is 2-fold. First, EMRs may be a good source of BMI/obesity data, which are often underreported in surveys and administrative databases. Second, EMRs provide an ideal means to track variables over time and, thus, allow longitudinal analyses of relationships …

Comparison Of Multi-Detector Ct Venography And Venous Sonography For Detecting Lower Limb Deep Venous Thrombosis In Patients With Suspected Pulmonary Embolism, Ruth Wanjohi

Master of Medicine in Imaging and Diagnostic Radiology

Objective: This was a prospective analytic study that aimed to compare the agreement between CT pulmonary angiography (CTPA/CTV) and ultrasonography (US) for diagnosis of thromboembolic disease and determine the sensitivity, specificity, positive and negative predictive values of the 2 tests using the presence of thromboembolic disease as a reference standard. Methods: 76 consecutive patients who were referred for CTPA at the Radiology department of Aga Khan University Hospital over an 8 month period between December 2008 and July 2009 were included in the study. All the patients underwent combined CTPA/CTV according to the usual departmental protocol. They subsequently had bilateral …

Cervical Vascular And Upper Airway Asymmetry In Velo-Cardio-Facial Syndrome: Correlation Of Nasopharyngoscopy With Mra, Avi G. Oppenheimer, Susan Fulmer, Keivan Shifteh, Ja-Kwei Chang, Allan Brook, Alan L. Shanske, Robert J. Shprintzen

Communication Disorders Faculty Publications

Purpose

Velo-cardio-facial syndrome (VCFS), the most common genetic syndrome causing cleft palate, is associated with internal carotid and vertebral artery anomalies, as well as upper airway asymmetry. Medially displaced internal carotid arteries, often immediately submucosal, present a risk of vascular injury during pharyngeal flap surgery for velopharyngeal insufficiency (VPI). We evaluate the frequency and spectrum of cervical vascular anomalies in a large cohort of VCFS patients correlating MRA with nasopharyngolaryngoscopy in detecting at risk carotid arteries. Furthermore, we assess the relationship with respect to laterality between cervical vascular patterns and the asymmetric abnormalities of these subjects’ upper airways.

Methods

Cervical …

Marital Satisfaction And Intimacy: Gender Role Attitudes And Spousal Support In Botswana, Kagelo Henry Rakwena

Loma Linda University Electronic Theses, Dissertations & Projects

In this study, the predictors of marital satisfaction and intimacy were examined within an African context that is characterized by a fast growing economy, migrant population, urbanization and industrialization. Specifically, this study examined the role of two relational variables, gender role attitudes and spousal support and two demographic variables, age and gender in predicting the variance in marital satisfaction and intimacy, after controlling for number of children, religion, occupation, education, length of marriage and household income among married individuals in Botswana. The results of this study reveal the importance of gender role attitudes and spousal support as key predictors of …

Hypoxia And Fetal Programming Of Cardiovascular Dysfunction, Qin Xue

Loma Linda University Electronic Theses, Dissertations & Projects

Human epidemiological studies have shown a clear association of adverse intrauterine environment and an increased risk of ischemic heart disease in later adult life. Of all the stresses to which the fetus is subjected, perhaps the most important and clinically relevant is that of hypoxia. The goal of this project is to test the hypothesis that chronic hypoxia during gestation adversely affects fetal cardiovascular development and impairs cardiac function in offspring. In the first part of project, we tested the hypothesis that chronic hypoxia adversely regulates contractility of fetal pulmonary arteries and veins in sheep residing at high altitude (3,801 …

A Critical Constructionist View Of "At-Risk" Youth In Alternative Education, Rachelle Silverstein Touzard

Loma Linda University Electronic Theses, Dissertations & Projects

Family therapists and school counselors are increasingly called upon to provide services for youth in alternative education (Carver, Lewis, & Tice, 2010). Alternative education systems are programs for youth who have been defined as at risk. This study explored the at-risk discourse and asked the questions (a) how do youth and staff define the term at risk, (b) construct their experience in alternative education systems, and (c) experience their relationships with each other.

Combined elements from critical theory and a social constructionist perspective guided this study. A qualitative, grounded theory method was used that included semi structured interviews with …

Therapeutic Modalities Targeting Neuroinflammation After Neonatal Hypoxia-Ischemia, Nancy Fathali

Loma Linda University Electronic Theses, Dissertations & Projects

Hypoxia-ischemia (HI) occurs in 1-6/1000 live full-term births (Shankaran, 2009). Of those affected, 15-20% will die in the postnatal period, and 25% of survivors will be left with long-term neurological disabilities (Gunn, 2000; Vannucci, 1997; Fatemi, 2009). It has become increasingly clear that peripheral immune cells infiltrate the brain parenchyma as part of the physiological response to tissue damage after HI injury. The interplay between infiltrating immune cells and brain resident cells during the inflammatory response is however dynamic and complex; in that neuro-immune crosstalk, by way of specific molecular mediators, is responsible for both neurodestructive as well as neuroprotective …

Stressors And Coping Mechanisms Of Married Female Physicians : A Qualitative Review, Eva Marie Starner

Loma Linda University Electronic Theses, Dissertations & Projects

Female physicians live and work in a very complex world fraught with professional demands and personal challenges. Twenty-seven married female physicians were interviewed for this study to assess demands and stressors endemic to them and to determine how they manage them. The breadth of this study looked at the demands and stressors of the female physician from the perspective of her work environment, home and family responsibilities, parenting responsibilities, and self-imposed demands in her perceived roles as a working wife and mother. Two main categories emerged during the development of grounded theory: System Challenge and System Adaptation. Additionally, work demands, …

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 …

Aerobic Exercise And Bone Turnover In Trained And Untrained Premenopausal Women, Michelle Prowse

Loma Linda University Electronic Theses, Dissertations & Projects

Regular weight-bearing exercise is recommended for healthy young adults to optimize bone mineral density (BMD) (Physical Activity Guidelines Advisory Committee, 2008). BMD alone however, is not a significant predictor of osteoporosis or fracture risk. While bone turnover markers are used clinically to assess efficacy of pharmacological intervention in individuals diagnosed with osteoporosis, they may also have a role in evaluating acute responses to exercise. The purpose of this dissertation was to compare two groups of premenopausal women, those which are sedentary (low fitness) versus those that are well-trained (high fitness), by BMD and bone turnover markers at rest and the …

Therapeutic Modalities And Educational Approaches In Clergy Stress Reduction, Shaun Tress Campbell

Loma Linda University Electronic Theses, Dissertations & Projects

Clergy are listed among administrators, social workers, healthcare providers, fire fighters, and police officers as professionals with high levels of occupational stress (Hill et al., 2003; Greenberg, 1990). Clergy are valuable resources to the American culture in that they perform an array of services to comfort and assist others. From natural catastrophes to personal misfortune, pastors are often expected to be present to offer consolation or to extend ecclesiastical services. Researchers have found that pastors are the primary mental health counselors for tens of millions of Americans (Weaver et al., 2002). Darling et al. (2004) report, "Clergy in U.S. culture …

Emergency Department Staff Adherence To Bad News Delivery Recommendations, Kristen R. Myers

Loma Linda University Electronic Theses, Dissertations & Projects

Emergency department (ED) staff is responsible for giving bad news regarding death, diagnoses, and other traumatic losses to patients and loved ones. Individuals receiving traumatic and sudden bad news are at increased risk of serious psychological and physiological consequences of disrupted grief. Despite published recommended practices for providers to help prevent maladaptive grief responses, little research is available on actual bad news delivery practices and factors promoting or hindering adherence to recommendations, and no study specifically explored the ED context.

The study used a qualitative design to explore bad news delivery practices, awareness of recommendations, factors perceived to hinder or …

Fetal Programming By Nicotine Increases Cardiac Susceptibility To Ischemic Injury, Jennifer Charlotte Alexie Lawrence

Loma Linda University Electronic Theses, Dissertations & Projects

Fetal programming is the area of study that focuses on the prenatal origins of adult onset disorders. Previous studies have associated an adverse prenatal environment with the onset of physiologic and metabolic diseases during adulthood. Fetal malnutrition, hypoxia, and exposure to drugs - such as cocaine and nicotine - have been associated with adult disease states. Cigarette smoking is the number one cause of preventable death in the developed world. Among the many dangerous chemicals found in tobacco products is nicotine, the compound responsible for the addictive nature of tobacco use. Nicotine use during pregnancy is a known cause of …

Psychosocial Factors Associated With Nicotine Dependence Among College Students : Are There Differences Between Social And Regular Smokers?, Devan Rae Romero

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Cigarette smoking, the primary source of tobacco used by adults 18-25, has remained stable, at around 21-25%, in the college population since 2003. Many college students report their smoking as primarily a “social” behavior, which may reflect an emerging type of smoker. Ambiguity exists in defining and categorizing smokers in the college population.

Purpose. The purpose of this study was to examine psychosocial perceptions related to smoking among college students who currently smoke and those who do not smoke, and among different types of smokers. In addition, validation of self-reported smoking behavior with saliva cotinine was conducted in …

Ricin B Chain-Insulin Fusion Protein Immunomodulation Of Type 1 Diabetes, James Edward Carter Iii

Loma Linda University Electronic Theses, Dissertations & Projects

Type 1 diabetes mellitus (T1D) is a debilitating chronic inflammatory disease of the insulin-producing pancreatic islet β-cells that results from a combination of genetic and environmental factors. Attempts to suppress Th1-mediated autoimmune diseases such as T1D by mucosal delivery of autoantigens for immunotolerization have yielded only partial success. Attainment of satisfactory levels of sustained immunological tolerance remains to be accomplished. To restore self-tolerance requires delivery of sufficient amounts of autoantigen to stimulate regulatory T helper cells that function to survey the gut and induce tolerance to consumed antigens such as food. Oral delivery of autoantigens has previously been shown to …

Effect Of Depression On Attention Via Mood Induction In A Healthy Population, Cheryl Mae Calvano

Loma Linda University Electronic Theses, Dissertations & Projects

This project continues research into the cognitive attention of persons with a sad mood similar to that experienced by dysthymia. The project utilizes the Dot Probe Task to evaluate attention to affective stimuli presented in the International Affective Picture Set (IAPS). Participants were psychology students recruited from La Sierra University. Participants completed a word task that intended to induce a sad or neutral mood. The Positive and Negative Affect Scale (PANAS) was used to evaluate the efficacy of the mood induction. Overall, participant’s negative PANAS scale did not differ between groups. Groups differed between administrations of the PANAS on the …

Optimal Technical Management Of Stump Closure Following Distal Pancreatectomy: A Retrospective Review Of 215 Cases., Lisa J. Harris, Hamid Abdollahi, Timothy Newhook, Patricia K. Sauter, Albert G. Crawford, Karen A. Chojnacki, Ernest L. Rosato, Eugene P. Kennedy, Charles J. Yeo, Adam C. Berger

Department of Surgery Faculty Papers

BACKGROUND: Pancreatic fistula (PF) is a major source of morbidity following distal pancreatectomy (DP). Our aim was to identify risk factors related to PF following DP and to determine the impact of technique of transection and stump closure.

METHODS: We performed a retrospective review of 215 consecutive patients who underwent DP. Perioperative and postoperative data were collected and analyzed with attention to PF as defined by the International Study Group of Pancreatic Fistula.

RESULTS: PF developed in 36 patients (16.7%); fistulas were classified as Grade A (44.4%), B (44.4%), or C (11.1%). The pancreas was transected with stapler (n = …

Bone Density Measurement Via Radiographic Calibration, Amber Jean Bowen

Master's Theses

Musculoskeletal injuries are the most common injuries sustained by athletes and military recruits and can result in decreased performance and lifelong disability. So common and costly are these injuries that the American Academy of Orthopedic Surgeons has provided guidelines for future research, including recommendations for the development of a large animal model of bone injury (USDA 2001). In human and veterinary medicine, digital radiography represents the primary diagnostic tool the physician uses to diagnose skeletal injury. Advances in digital radiography have provided the veterinarian with opportunities to make both simple and complex radiographic assessments. We investigated a simple quantitative measurement …

Comparison Of Ge Centricity Electronic Medical Record Database And National Ambulatory Medical Care Survey Findings On The Prevalence Of Major Conditions In The United States., Albert G. Crawford, Christine Cote, Joseph Couto, Mehmet Daskiran, Candace Gunnarsson, Kara Haas, Sara Haas, Somesh C Nigam, Rob Schuette, Joseph Yaskin

College of Population Health Faculty Papers

The study objective was to facilitate investigations by assessing the external validity and generalizability of the Centricity Electronic Medical Record (EMR) database and analytical results to the US population using the National Ambulatory Medical Care Survey (NAMCS) data and results as an appropriate validation resource. Demographic and diagnostic data from the NAMCS were compared to similar data from the Centricity EMR database, and the impact of the different methods of data collection was analyzed. Compared to NAMCS survey data on visits, Centricity EMR data shows higher proportions of visits by younger patients and by females. Other comparisons suggest more acute …

Making Lemonade Out Of Lyme, Kaela M. Gallagher

Social Sciences

No abstract provided.

Fetal Alcohol Spectrum Disorder, Mary (Katie) Busmire

Psychology and Child Development

This is a senior project about fetal alcohol spectrum disorder (FASD). Fetal Alcohol Spectrum Disorder (FASD) is the term given to a child who has been affected by exposure to prenatal alcohol. Drinking during pregnancy can lead to several physical, neurological and behavioral effects. However, there are several interventions that can help minimize the effects of prenatal alcohol. Focusing on family interventions and therapies will best benefit the lives of children with FASD and their families.

Human Coronaviruses Are Uncommon In Patients With Gastrointestinal Illness, Frank Esper, Zhen Ou, Yung T. Huang

Faculty Scholarship

BACKGROUND: Coronaviruses infect numerous animal species causing a variety of illnesses including respiratory, neurologic and enteric disease. Human coronaviruses (HCoV) are mainly associated with respiratory tract disease but have been implicated in enteric disease. OBJECTIVES: To investigate the frequency of coronaviruses in stool samples from children and adults with gastrointestinal illness by RT-PCR. STUDY DESIGN: Clinical samples submitted for infectious diarrhea testing were collected from December 2007 through March 2008. RNA extraction and RT-PCR was performed for stools negative for Clostridium difficile using primer sets against HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1. Clinical data from samples positive for coronaviruses were reviewed …

Influence Of Type 2 Bovine Viral Diarrhea Virus NPro On Enhancement Of Bovine Respiratory Syncytial Virus Replication Mediated By Antagonism Of Host Cell Interferon Type I Responses, Abdulrahman Abdulaziz A. Alkheraif

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Bovine viral diarrhea virus (BVDV) is a member of the genus Pestivirus, Family Flaviviridae. The virus can infect many species of animals of the order Artiodactyla. The BVDV genome encodes an auto protease, N^pro, that degrades interferon regulatory factor-3 (IRF-3) reducing type I interferon (IFN-I) production from host cells. Bovine respiratory syncytial virus (BRSV) is a member of the genus Pneumovirus, Family Paramyxoviridae. Concurrent infection with BVDV and BRSV causes more severe respiratory and enteric disease than infection with either virus alone. Our hypothesis was that N^pro modulates the innate immune responses to BVDV infection …

Vampirism, Vampire Cults And The Teenager Of Today, Megan White, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper is to summarize the limited literature on clinical vampirism, vampire cults and the involvement of adolescents in vampire-like behavior. The various definitions of clinical vampirism are outlined and the emergence of vampire cults from Gothic culture is examined. Further, the clinical features of cult behavior, the attraction to cults, the risk factors for cult involvement, and the clinical management of cult members are discussed. Additionally, vampire popular media is briefly introduced and a case study presented.

Psychological And Support Characteristics Of Parents Of Child Sexual Abuse Victims: Relationship With Child Functioning And Treatment, Poonam Tavkar

Department of Psychology: Dissertations, Theses, and Student Research

Child sexual abuse continues to be a prevalent and complex problem in today’s society as it poses serious and pervasive mental health risks to child victims and their non-offending parents. The main objectives of this study were (a) to elucidate the psychological symptoms and support needs of parents of child sexual abuse victims as they present to group treatment, (b) to examine changes in psychological symptoms and support needs and their relationship with child functioning over the course of a parallel group treatment, and (c) to examine the impact of these factors on completion of group treatment. Participants included 104 …

Defining And Measuring The Patient-Centered Medical Home., Kurt C Stange, Paul A Nutting, William L Miller, Carlos R Jaén, Benjamin F Crabtree, Susan A Flocke, James M Gill

Department of Family & Community Medicine Faculty Papers

The patient-centered medical home (PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership; 2) new ways of organizing practice; 3) development of practices' internal capabilities, and 4) related health care system and reimbursement changes. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare. The value of the fundamental tenets of primary care is well established. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to …

A Multicentric Open Clinicaltrial To Evaluate The Usefulness Of 13 Predefined Homoeopathic Medicines In The Management Of Acute Rhinitis In Children, Chaturbhuja Nayak, Vikram Singh, Krishna Singh, Hari Singh, Praveen Oberai, Varanasi Roja, Maya Padmanabhan, Sunil Prasad, Manu Arya

Indian Journal of Research in Homoeopathy

No abstract provided.

The Human Oral Microbiome Database: A Web-Accessible Resource For Investigating Oral Microbe Taxonomic And Genomic Information, Tsute Chen, Wen-Han Yu, Jacques Izard, Oxana V. Baranova, Abirami Lakshmanan, Floyd E. Dewhirst

Department of Food Science and Technology: Faculty Publications

The human oral microbiome is the most studied human microflora, but 53% of the species have not yet been validly named and 35% remain uncultivated. The uncultivated taxa are known primarily from 16S rRNA sequence information. Sequence information tied solely to obscure isolate or clone numbers, and usually lacking accurate phylogenetic placement, is a major impediment to working with human oral microbiome data. The goal of creating the Human Oral Microbiome Database (HOMD) is to provide the scientific community with a body site-specific comprehensive database for the more than 600 prokaryote species that are present in the human oral cavity …

Multiport Minimally Invasive Skull Base Surgery: How Many Ports Are Too Many?, Yaron A. Moshel, Theodore H. Schwartz

Department of Neurosurgery Faculty Papers

Surgical access to the ventral skull base has evolved considerably over the past several years with the introduction of minimally invasive endoscopic and endoscope-assisted approaches. The accompanying manuscript by Ciporen et al. demonstrates an addition to this growing body of literature in their description of the feasibility of multiportal endoscopic approaches to the skull base, particularly the precaruncular transorbital approach, in a series of cadaver dissections. Similar to laparoscopic abdominal surgery, which utilizes multiple small ports to improve visualization and manipulation, they envision a modular combination of approaches that allows an endoscope to be placed in one port and surgery …

Evaluating Microfossil Content Of Dental Calculus From Brazilian Sambaquis, Verônica Wesolowski, Sheila Maria Ferraz Mendonça De Souza, Karl Reinhard, Gregório Ceccantini

Karl Reinhard Publications

To date, limited numbers of dental calculus samples have been analyzed by researchers in diverse parts of the world. The combined analyses of these have provided some general guidelines for the analysis of calculus that is non-destructive to archaeological teeth. There is still a need for a quantitative study of large numbers of calculus samples to establish protocols, assess the level of contamination, evaluate the quantity of microfossils in dental calculus, and to compare analysis results with the literature concerning the biology of calculus formation. We analyzed dental calculus from 53 teeth from four Brazilian sambaquis. Sambaquis are the shellmounds …