Physical Sciences and Mathematics Commons^™

Benefits And Barriers To Hiv Testing In A Population Of Federal Detention Inmates, Nicole A. Knight

Loma Linda University Electronic Theses, Dissertations & Projects

Voluntary HIV testing in combination with early medical intervention has been shown to be effective in reducing the rate of new infections and improving the health and life expectancy of those living with HIV. There are however several high-risk populations in the US that remain largely unreached by HIV testing efforts, some of which could be reached while they spend time in prison or jail. Per current Bureau of Prisons (BOP) policy, HIV testing is routinely offered only to “high risk” pretrial and sentenced inmates. We conducted a cross-sectional study with 721 pretrial and sentenced inmates who entered a large …

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 …

Perceived Attitudes And Staff Roles Of Community Based Outpatient Clinics In Disaster Management, Pauline Antoinette Hodge-Hilton

Loma Linda University Electronic Theses, Dissertations & Projects

Objective: Natural and manmade disasters have claimed the lives of thousands of individuals in the US and caused billions of dollars in property damage. First responders carry the responsibility of disaster management, leaving other health care professionals such as medical clinic staff underutilized to support the clinic staff. We explored how medical and support staff in Community-based Outpatient VHA Clinics (CBOC) perceive their roles in disaster response, their attitudes about clinic readiness and continuity of care during disasters, and their ability to function in a post disaster environment.

Methods: A mixed method study was conducted to answer questions related to …

Successful Aging And Creativity : An Investigation On Functional Status And Psychological Wellbeing In Older Adults, Mirie E. Levy

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: While the literature supports the maintenance of functional status as integral to successful aging, the relationship of creativity on functional status has received little attention. Creativity has been associated with health and aging in the research but only a small number of studies have examined creativity interventions to enhance functional status and boost psychological wellbeing.

Methods: A pretest-posttest quasi-experimental design was used to investigate an 8-week creativity intervention on functional status and psychological wellbeing in older adults. Sample subjects were 92 men and women all over age 60. A series of two-way mixed ANOVAs measured differences between treatment and …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

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 …

The Morbidity & Mortality Of Prevalent Heart Failure, Jennifer Kwon

Loma Linda University Electronic Theses, Dissertations & Projects

The first study population included 292 unselected consecutive patients from the LLUMC heart failure clinic who were enrolled in the study from January to July 2006 and were followed up through the end of December 2010. The treatment policy at the clinic was to uptitrate dosages of beta-adrenergic blockade (β-blockers), angiotensin-converting-enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) to the most tolerable levels in order to reach target dosages, as recommended by the Heart Failure Society of America (HFSA). Patients were classified into systolic heart failure (ejection fraction (EF) < 40%) or diastolic heart failure (EF≥40%). All dosages of β-blockers, ACEi and ARB were extracted through chart reviews and were used as the main predictors of the patients' survival. Results from analyses showed that reaching target dosages of β-blockers and ACEi/ARB may increase survival when compared to not reaching target among the systolic HF population (HR_{β_biockers}= 0.64, 95% CI 0.26-1.56 and HR_ACEi/ARB=0.50, …

The Efficacy Of An Audio Program And Discussion Guide In Promoting Exclusive Breastfeeding In Cameroon, Africa, Kathryn R. Reinsma

Loma Linda University Electronic Theses, Dissertations & Projects

Background: In the Northwest Region of Cameroon, approximately 90% of women initiate breastfeeding; however, only 34% continue exclusive breastfeeding for the recommended six months (Kakute, et al., 2005; WHO, 2008). Entertainment-education is a mass-media communication strategy of placing educational information into media such as television programs, movies, and radio programs (Siegel & Lotenberg, 2007). This form of behavioral change communication has proven effective in addressing health-related issues in developing countries.

Purpose: The aim was to design an audio program and discussion guide to test the hypothesis that an audio program and discussion guide improves exclusive breastfeeding knowledge, beliefs, benefits, self-efficacy, …

The Application Of Dialectical Behavior Therapy To Chronic Pain Management, Jacob S. Iwaszewski

Loma Linda University Electronic Theses, Dissertations & Projects

Pain affects more than 50 million Americans annually, costs over 150 billion dollars each year in healthcare and legal expenses, and results in decreased work productivity and missed work days (Ballantyne, 2006; Boll, Raczynski, & Leviton, 2004; Thom, 2004). It is estimated that chronic pain negatively impacts 15% to 33% of the US population (Bokarius et al., 2008). Third-wave acceptance-based therapies, such as Dialectical Behavior Therapy (DBT), have demonstrated significant improvements in mental health functioning for a variety of populations (Carmody & Baer, 2008; Cusens, Duggan, Thome, & Burch, 2010). DBT, one of the primary treatment modalities for Borderline Personality …

An Occupational-Based Experimental Study Of Collective Vs. Personal Efficacy To Encourage Sun Protective Behaviors In Head Start Preschool Teachers, Elizabeth A. Holzhauser

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Skin cancer is one of the most common types of cancers in the United States. An analysis of literature shows that skin cancer can be partially mitigated through personal behavior changes (Glanz, Buller, & Saraiya; 2007, Canadian Centre of Occupational Health and Safety [CCOHS], 2010). Currently national sun-safety educational campaigns promote sun-protective behaviors to individuals who receive exposure due to their work environment (Task Force on Community Preventive Services, 2004). Preschool teachers employed with San Bernardino County Head Start are inadvertently exposed to sunlight during mandatory recess periods posing risks to their health.

Purpose. This study evaluated two instructional …

Perceived Parent-Child Relationship And High-Risk Behaviors Among Christian College Students, Karla G. Lavin Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Adolescents and young adults today are participating in high-risk behaviors such as dangerous sexual behaviors and drug and alcohol abuse at high rates. An increased incidence of negative effects associated with the aforementioned behaviors has led researchers to examine factors that influence and protect adolescents from certain devastating effects (Davis, Hendershot, George, Norris, & Heiman, 2007; Goldstein, Bamett, Pedlow, & Murphy, 2007; Hamilton, et al., 2007; Hingson, Heeren, & Winter, 2006; Hingson, Heeren, Winter, & Wechsler, 2003; Hingson, Heeren, Zakocs, Winter, & Wechsler, 2003; McCarty, et al., 2004; Mokdad, Marks, Stroup, & Gerberding, 2004; Mosher, Chandra, & Jones, 2005; …

Impact Of An Online Support System On Health Related Quality Of Life Among Men Diagnosed With Prostate Cancer, Daniel K. Osei

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer is a major public health issue worldwide and a significant cause of male cancer death in the USA. Though early screening and treatment has greatly enhanced the outcome, men diagnosed with prostate cancer face problems that compromise quality of life after treatment. Online support for prostate cancer clients is a convenient way to help because it is anonymous, inexpensive, and can be used at clients’ convenience. Yet few studies have explored how these supports impact these clients. This study used a longitudinal randomized experimental design to examine the impact of online services on quality of life of prostate …

Relationship Of Vitamin D Levels To Blood Pressure In A Biethnic Cohort, Rosario O. Sakamoto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Serum hydroxyvitamin D [25(OH)D] has been well-accepted as not an ordinary vitamin but a pro-hormone that has many benefits beyond its well-known effects on bone. Cardiovascular risk factors such as hypertension remain a huge health burden and Blacks have been recognized to have higher prevalence of hypertension compared to non-Hispanic Whites. Despite increasing evidence of the benefits of vitamin D on blood pressure control, there is much more to be learned about the relationship of serum 25(OH)D to blood pressure among different ethnicities.

Purpose: The goal of this study was to determine whether vitamin D serum 25(OH)D levels were …

Factors That Inhibit Or Enhance Maternal Coping With Stillbirth In Chhattisgarh, India, Lisa R. Roberts

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Over half of the known stillbirths occur in four highly populated countries—India among them. While acknowledged as a significant public health issue in western societies, little is known about maternal coping with stillbirth in developing countries. The purpose of this mixed methods study is to explore how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India.

Methods: In Phase 1 of this mixed methods study, grounded theory methods were used to explore perceptions regarding stillbirth. A de-identified medical records review of 536 deliveries at Christian …

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 …

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …

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 …

Veterans Of The 1st Persian Gulf War: A Study Of Medically Unexplained Symptom Models, Alexis H. Collins

Loma Linda University Electronic Theses, Dissertations & Projects

In 1990-1991, shortly after the Persian Gulf War, a number of veterans began complaining about a wide range of symptoms, the most common of which were; fatigue, headache, sleep disturbance, low mood, and memory loss. These symptoms were similar to those experienced by individuals with Medically Unexplained Illnesses such as Chronic Fatigue Syndrome, Fibromyalgia, Irritable Bowel Syndrome, Multiple Chemical Sensitivity, and Somatoform Disorders. Utilizing structural equation modeling and data gathered from the Gulf War Veterans Health Questionnaire, this study attempted to determine whether symptoms experienced by veterans were best explained as individual items, discrete illnesses, or as a conglomeration of …

Comparison Of Non-Surgical And Surgical Endodontic Retreatment: A Systematic Review, Robert Corr

Loma Linda University Electronic Theses, Dissertations & Projects

Primary root canal therapy has been shown to be a predictable procedure with a high degree of success ^1-4, however failures can occur after treatment. Treatment options for the preservation of teeth that have had previous endodontic treatment but demonstrate persistent disease include non-surgical (orthograde) or surgical (retrograde) endodontic retreatment, assuming the tooth is restorable, periodontally sound, and the patient desires to retain the tooth. The purpose of this study was to conduct a systematic review of the current available evidence to compare the clinical and radiographic outcomes of nonsurgical with those of surgical endodontic retreatment. Methodology began with …

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, …

The Use Of The Minnesota Multiphasic Personality Inventory-Ii (Mmpi-2) In Pre-Employment Evaluations, Ana M. Gamez

Loma Linda University Electronic Theses, Dissertations & Projects

Psychological testing is an important facet in the selection and hiring processes of law enforcement and public safety personnel. Research in this area suggests that the MMPI-2 scales have been correlated with problematic behavior among police officers, poor job performance, and officer misconduct. This study examined the extent to which suitability for hire could be predicted by the MMPI-2 scale L (Lie), scale K (correction), Infrequency scale (F), scale 4 Psychopathic Deviate (Pd), scale 6 Paranoia (Pa), scale 7 Psychasthenia (Pt), and scale 9 Hypomania (Ma). It examined whether profile differences emerged as a function of suitability across gender, between …

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 …

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 …

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 …

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 …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

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, …

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 …