Medical Specialties Commons^™

Preventive Care Utilization Among Black Women : Perceived Beliefs, Benefits And Barriers To Mammography Screening, Rowandalla Y. Dunbar

Loma Linda University Electronic Theses, Dissertations & Projects

Blacks, in comparison to other racial or ethnic groups, suffer higher rates of illness and death from many preventable or treatable diseases. Despite the significantly higher rates of mortality and disease, Blacks are least likely to utilize clinical preventive care services. Black women, who are more likely to have advanced breast cancer at time of diagnosis (Chu, Lamar, & Freeman, 2003) are least likely to seek mammography screening (National Health Interview Study, 2000). Allen, Bastani, Bazargan and Leonard (2002) examined predictors of mammography screening among women 40 years old and older residing in the South Central area of Los Angeles, …

Body Image Satisfaction In Infant And Pediatric Cardiac Transplant Recipients As Adolescents, Danusia Nedilskyj

Loma Linda University Electronic Theses, Dissertations & Projects

With the long-term survival rate of infant and pediatric heart transplant recipients reaching as high as 85%, there is now a significant number of these youths entering adolescence. Although psychological factors thought to be associated with pediatric heart transplant have reached clearer delineation in the literature, few studies have been conducted. Given the emphasis on development typically seen in adolescence combined with the unique experience of receiving a heart transplant, factors such as body image, self-perception, stress and mood have emerged from the literature. As such, this study assessed psychosocial variables of body image satisfaction, self-concept, depression, and social stress …

Facial Type Analysis Comparison Between Mri, Cbct, And Lateral Cephalometrics, Matthew A. Sanders

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Single Cephalometric measurements are comparable between Cone Beam Computed Tomography (CBCT), Magnetic Resonance Imaging (MRl) and Conventional Lateral Cephalometric (LC) imaging methods. This study evaluated the agreement between the three imaging methods in facial type analysis (using a composite of 5 cephalometric measures).

Methods and Materials: Twenty-two subjects participated in this study. Cranial images were generated via three modalities: LC, CBCT and MRl. Cephalometric landmarks were identified on the three images per subject and a facial type analysis performed. An equally weighted facial type calculation composed of 5 cephalometric measurements (facial axis, facial depth, mandibular plane, lower face height, …

Correlating The Slope Of The Vomer With Cephalometric Vectors Of Facial Growth, Ryan Michael Pulfer

Loma Linda University Electronic Theses, Dissertations & Projects

It is important for orthodontists to have a basic understanding of the growth and development of the face. Scott's nasal septal cartilage theory proposes that the cartilage of the nasal septum proliferates along the anterior slope of the vomer bone by interstitial growth, simultaneously pulling and displacing the maxilla downward and forward. It is therefore logical to conclude that the vector of nasomaxillary growth has a geometric correlation with the anterior slope of the vomer bone.

There are no published studies comparing either the anterior or posterior slope of the vomer with any lateral cephalometric landmarks, the vectors of nasomaxillary …

Creating Prediction Models For Obstructive Sleep Apnea Based On Gender, Jeffrey Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Obstructive sleep apnea (OSA) is a common chronic disorder that is characterized by repetitive episodes of airflow cessation or reduction occurring during sleep as a result of partial or complete upper airway obstruction. These recurrent events have a tremendous impact on the cardiovascular system with a multitude of dangerous consequences. Numerous studies have been conducted determining etiological risk factors for OSA including anatomical predictors which have been observed with multiple imaging techniques. Cone beam computed tomography (CBCT) is a low-radiation mode of imaging that can be used to accurately identify anatomical landmarks and measure craniofacial relationships and airway dimensions. …

Microct Study Of Critical-Sized Defects Restored With A New Rhbmp-2 Carrier, Joanne S. Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction: Regenerating bone in critical-sized maxillofacial osseous defects remains a challenge. The utilization of recombinant human bone morphogenetic protein-2 (rhBMP-2) to form new bone has been shown to be a promising alternative to autogenous bone grafts, and the development of a carrier matrix to effectively deliver the rhBMP-2 has been identified as the critical factor necessary for the successful clinical application of rhBMP-2. The objective of this study was to perform a microCT analysis to examine the density of reconstructed bone using different rhBMP-2 carriers in critical-sized defects.

Material and Methods: Critical-sized defects (approximately 2.5 cm) were created in the …

Psychological Profiles In A Female Bariatric Surgery Sample, Aimee L. Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Morbid obesity is an epidemic. Current literature suggests that people with morbid obesity tend to show increased levels of psychological dysfunction. This is especially pertinent to the clinicians who work with morbidly obese patients who seek bariatric surgery as the method for weight control. Surgery should be performed on patients who are psychologically ready to adjust to the stringent post-operative lifestyle.

The purpose of the present study was (1) to compare two groups of bariatric patients (a White group and a non-White group) on pre-surgery measures: specific scales on the Millon Behavioral Medicine Diagnostic (MBMD), the Beck Depression Inventory II …

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, & …

The Relationship Between The Level Of Support Group Participation And Psychosocial Factors In Prostate Cancer Patients Treated With Proton Therapy, Carol A. L. Davis

Loma Linda University Electronic Theses, Dissertations & Projects

Background. The role of support groups for cancer patients is known to be beneficial in helping people adjust to the disease, and cope with the myriad of effects that cancer has on quality of life. Although many people express interest in attending such support groups, few attend regularly. It is unclear what characteristics distinguish those who use such services from those who do not, especially among proton therapy patients.

Objective. To examine demographic and psychosocial characteristics associated with the Brotherhood of the Balloon (BOB) prostate cancer support group membership, a unique treatment-focused group originating at Loma Linda University Medical Center …

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 …

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 …

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 …

Regulation Of Pim1 Under Hypoxia In Prostate Cancer, Eva Sahakian

Loma Linda University Electronic Theses, Dissertations & Projects

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

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, …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

Materials and Methods: Twelve …

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), …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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 …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

Effect Of California Mission Fig Consumption On Levels Of C-Reactive Protein And Antioxidant Levels, Rasha Abdrabou

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols exert anti-inflammatory and antioxidant effects. We investigated the effect of consumption of polyphenol-rich figs on high sensitivity C-reactive protein (CRP) and antioxidant levels in hyperlipidemic subjects. The purpose of this study was to examine the effect of fig consumption on C-reactive protein and antioxidant levels. Analyses were carried out on collected data from September to December of 2008. Using a crossover design, one hundred and two participants were recruited and randomized into an intervention phase (eating figs) and a control phase (not eating figs) for 5 weeks. Blood samples were drawn from each group at the 4th and 5th …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

Attitudes And Beliefs That Predict Taiwanese Older Adults' Intentions To Attend Strength And Balance Training Programs, Shih-Fan Lin

Loma Linda University Electronic Theses, Dissertations & Projects

The rate of participation in the strength and balance training (SBT) program, an effective fall prevention intervention, is very low among older adults. To increase older adults' participations in SBT programs, this study involved an observational and cross-sectional study design to understand factors that affect Taiwanese older adults' intention to attend SBT programs utilizing the theory of planned behavior. Questionnaires that measured constructs of the theory of planned behavior (attitude, subjective norm, perceived behavioral control, and behavioral, normative, and control beliefs) were collected from 221 community-dwelling Taiwanese elderly women between the age of 55 and 94. Simple correlations and multiple …

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, …

Correlates Of Soy Food Consumption In Adventist Health Study-2, Yen Ang

Loma Linda University Electronic Theses, Dissertations & Projects

Much has been discussed about the health benefits and risks of soy consumption but very little is known about who the consumers are. Most of what is known has been observed mainly in Asian populations who consume high levels of soy. Very little is known about soy food intake in the western population who typically has low consumption level. The Seventh-Day Adventist cohort in North America is the only population known in the West with soy food intake that is comparable to the Asian population living in the East.

Soy consumers in a population known for its healthier lifestyle and …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

Psychological Distress And Change In A Pediatric Obesity Population, Amy Rebecca Beck

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric overweight and obesity is a growing national epidemic with 15 percent of children ages 6-19 considered obese and at least 22 percent considered overweight. While there is considerable research pointing to contributing factors of obesity, there is a paucity of research which elucidates what contributes to successful intervention. Considering that by the year 2050, nearly 50 million Americans may be obese, understanding the factors delineating success of weight loss and prevention is a necessity. The purpose of this study was to utilize archival data from the LLU Growing Fit Program to evaluate the levels of psychological distress experienced by …

Comparison Of Mandibular Alveolar Bone With Facial Type Using Cbct, Jason M. Loop

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the relationship between facial type and cortical bone thickness (mm), cortical bone density (rHU) and trabecular bone density (rHU) in the mandibular alveolar bone. Twenty-five consecutive dolichofacial, 25 consecutive mesiofacial, and 25 consecutive brachyfacial patients with T1 lateral cephalograms and CBCT scans were used in this study. A Ricketts analysis was used to compute the VERT index for each patient. All statistical analyses were performed at the significance level of α = 0.05. The one-way ANOVA and LSD post hoc tests indicated there was a statistically significant relationship between facial type and …