Statistics and Probability Commons^™

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

Body Weight And Mortality Among Adults Who Never Smoked, Pramil N. Singh

Loma Linda University Electronic Theses, Dissertations & Projects

Most prospective studies identify an increased mortality risk for adults of high body mass index (> 27 kg/m²) that is commonly attributed to the effects of excess body fat, and also identify an increased mortality risk for adults of low body mass index (< 21 kg/m²), an association that, if causal among healthy adults, is without adequate pathophysiologic support.

In this dissertation, I have conducted three studies that continue the investigation of adiposity in relation to mortality among never-smoking adults of the California Seventh-day Adventist population. Among never-smoking adults of the Adventist Mortality Study (1960-1985), the relation between …

Assessing The Accuracy Of A New Diagnostic Test When A Gold Standard Does Not Exist, Todd A. Alonzo, Margaret S. Pepe

UW Biostatistics Working Paper Series

Often the accuracy of a new diagnostic test must be assessed when a perfect gold standard does not exist. Use of an imperfect test biases the accuracy estimates of the new test. This paper reviews existing approaches to this problem including discrepant resolution and latent class analysis. Deficiencies with these approaches are identified. A new approach is proposed that combines the results of several imperfect reference tests to define a better reference standard. We call this the composite reference standard (CRS). Using the CRS, accuracy can be assessed using multistage sampling designs. Maximum likelihood estimates of accuracy and expressions for …

A Longitudinal Study Of Hospitalization Rates For Patients With Chronic Disease: Results From The Medical Outcomes Study., Eugene C. Nelson, Colleen A. Mchorney, Willard G. Manning, W H. Rogers

Dartmouth Scholarship

To prospectively compare inpatient and outpatient utilization rates between prepaid (PPD) and fee-for-service (FFS) insurance coverage for patients with chronic disease. Data from the Medical Outcomes Study, a longitudinal observational study of chronic disease patients conducted in Boston, Chicago, and Los Angeles.A four-year prospective study of resource utilization among 1,681 patients under treatment for hypertension, diabetes, myocardial infarction, or congestive heart failure in the practices of 367 clinicians.

An Administrative View Of Model Uncertainty In Public Health, Clark D. Carrington

RISK: Health, Safety & Environment (1990-2002)

Dr. Carrington reviews several ways to deal with model uncertainty, including those failing to acknowledge any use of models. He then evaluates six such methods with regard to, e.g., transparency and cost of execution.

Methodological And Substantive Issues In Substance Abuse Prevention Research, C. Anderson Johnson, John W. Farquhar, Steve Sussman

CGU Faculty Publications and Research

This article summarizes current issues in drug abuse prevention research through integration of other articles in this journal and by heeding historical trends in prevention science. Recommendations are made for future research directions. For prevention to advance, iterative processes are needed involving both quasi-experimental and experimental designs and involving both small, simple units and large, complex, interactive units. Accuracy of measurement and replication are of paramount importance.

Association Between Nutrient Intake And Risk Of Coronary Heart Disease In California Seventh-Day Adventists, Peter Pribiš

Loma Linda University Electronic Theses, Dissertations & Projects

Dietary habits are believed to be major determinants of risk of coronary heart disease (CHD). Studies of high and low risk populations have suggested several nutrients to be protective or hazardous against CHD. Most published work since 1984 on diet and CHD in the Adventist Health Study (AHS) population examined either foods or food groups. This study investigated ten nutrients as exposure variables and their relationship to CHD risk. A cohort of 23,616 nonsmoking, non-Hispanic white California Seventh-day Adventists was followed for six years beginning in 1976. Extensive dietary information was collected at baseline, as well as values of traditional …

Student Evaluations Of Teaching Effectiveness: The Interpretation Of Observational Data And The Principle Of Faute De Mieux, B. Burt Gerstman

Faculty Publications

Student opinion surveys are important but widely misunderstood tools for evaluating teaching effectiveness. In this brief review, an analogy is drawn between the use and interpretation of observational data for public health and biomedical research and the use of student opinion data in evaluating teach ing effectiveness. Sources of systematic error in the form of selection bias, information bias, and confounding are defined and illustrated. Original data concerning intermittent "quid pro quo" confounding (i.e., the effect of expected grades on student evaluations of teaching) are presented. Finally, the principle of faute de mieux ("lack of anything better") and the interpretation …

The Media, Risk Assessment And Numbers: They Don't Add Up, Sharon M. Friedman

RISK: Health, Safety & Environment (1990-2002)

Professor Friedman argues that, for risks to be reported accurately, journalism educators must help their students understand science, numbers and statistics.

The Impact Of A Primary Health Care Training Program On Morbidity In Kiyeyi, Rural Uganda, 1986-1991 : An Evaluation Of The Uganda-Finland Health Care Program, Marja-Leena Salin

Loma Linda University Electronic Theses, Dissertations & Projects

This study examines the effects of primary health care education efforts in reducing the disease case rates of acute respiratory infections, diarrhoea, malnutrition and measles in a rural Ugandan population between 1986 and 1991.

The intervention, a health education program offered by the Kiyeyi Health Center staff, consisted of a 12-week intensive training for community health workers and traditional birth attendants. Follow-up and supervision took place at regular intervals and continuing education was arranged every other year. Beginning in 1986, this training program was introduced in the first of seven clusters of villages, then expanded successively on an annual basis …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

Dysfunctional Attitudes, Life Stress And Coping Processes, Deborah Desalliers

Loma Linda University Electronic Theses, Dissertations & Projects

The findings of recent investigations earmarked chronic daily stressors as being highly related to stress levels. In addition, researchers are promoting a more integrative model of stress. The stress response is no longer thought of in strictly linear terms, i.e. an event causes stress. Rather, cognitive factors, existing within the human mind itself, strongly influence our coping processes and the chronic stress we experience.

Canonical correlation analysis was used to study how dysfunctional attitudes, a negative cognitive factor, were related to individuals' daily hassles and coping processes. An increase in dysfunctional attitudes was found to correspond to an increase in …

Predictive Probabilities In Employee Drug-Testing, John M. Gleason, Darold T. Barnum

RISK: Health, Safety & Environment (1990-2002)

Substance abuse in the U.S. has been estimated to cost $99 billion annually through lower productivity. Yet the authors urge caution in attempting to reduce these costs and health and safety Risks. In doing so, they cite commonly high frequencies of false negatives and false positives in employee drug tests - the latter having the potential to do great injustice to many drug-free employees.

Misfit Between Motivational Style And Type Of Job Demand As A Factor In Developing Occupational Stress, Arlene Gray Blix

Loma Linda University Electronic Theses, Dissertations & Projects

Occupational stress is costly in terms of human suffering and impaired organizational effectiveness. Occupational stress involves the interface between the individual worker and the work environment. The purpose of the study was to analyze the fit between motivational style and the type of job demands as a contributing factor in developing occupational stress symptoms. A literature review of occupational stress models was conducted. The six models compared and contrasted included the Person-Environment fit model (French, Rodgers, & Cobb, 1974), Integrative Transactional Model (Schuler, 1982), Organizational Stress Models (Ivancevich & Matteson, 1987; Parker & DeCotiis, 1983), Facet Analysis Model (Beehr & …

Anthropometric Parameters In Public School Students And Seventh-Day Adventist Vegetarian And Meat-Eating Students, Joan Sabaté-Casellas

Loma Linda University Electronic Theses, Dissertations & Projects

Concerns have been expressed for the ability of some vegetarian diets to support normal growth of children. Animal protein or meat intake showed a positive relationship to attained height in children from developing countries. In this study, the relationship between meat intake/vegetarian status and physical growth was investigated in children living in California.

Height and weight were collected on 2,272 Caucasian children aged 6-18 years attending Seventh-day Adventist (SDA) or public schools who participated in a two year longitudinal study. Age-, sex-, and school-specific mean heights and weights were at or above the national reference values. Sex-specific, age-adjusted regression analysis …

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

Loma Linda University Electronic Theses, Dissertations & Projects

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

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

Correlates Of Birth Weight And Gestation Age : Baseline Data For Health Education, Adanetch Kidanemariam

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose. The study examined the correlation of maternal occupation, urinary tract infection, smoking, and working during pregnancy with infant birth weight and gestational age in order to generate baseline data for development of a health education intervention program protocol for pregnant women In the work place.

Primary Hypotheses. (1) The four maternal risk factors: (a) occupation during lifetime, (b) reported urinary tract infection, (c) cigarette smoking, (d) working, are individually and interactively correlated with infant birth weight and gestational age. (2) The effects of the interactive associations are greater on birth weight than gestational age.

Procedure. A sample of …

The Effects Of An Intervention Program On Nursing Burnout, Maria Rosa-Morales

Loma Linda University Electronic Theses, Dissertations & Projects

The risk for professional burnout has become commonly recognized and in the past several years has been a focus of research efforts. Nursing is one of the professions generating a high level of stress which results in burnout.

The purpose of this study was to test the effects of an intervention program for nurses who felt they were experiencing burnout. Nursing burnout was defined as a chronic condition of stress among nurses, which leads to a syndrome of emotional exhaustion, depersonalization, and lack of personal accomplishment. The design used was a true experiment. Fifty-two nurses served as voluntary participants who …

Smoking Behavior Among Alabama Student Nurses : The Role Of Behavioral Beliefs And Normative Referencing, Judith Rausch

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine predictors of smoking behavior for the senior student nurses in the state of Alabama using Ajzen and Fishbein's Theory of Reasoned Action. Smoking prevalence by level of educational preparation and selected health behaviors were examined for relationship to cigarette use.

A sample of 11 schools of nursing were selected from Alabama's 34, using a random numbers table. There were 13 total programs as two of the schools had both A.D. and B.S. nursing programs. Thirty-two percent (N=555) of senior A.D., B.S. & diploma students nurses in Alabama responded to an 87 item …

Chronic Respiratory Disease Symptom Effects Of Long-Term Cumulative Exposure To Passive Tobacco Smoke And To Ambient Levels Of Tsp, Oxidants, So2, And No2 In Southern California, Gary L. Euler

Loma Linda University Electronic Theses, Dissertations & Projects

To assess risk of chronic respiratory disease symptoms due to long-term exposure to the ambient levels of TSP, oxidants, SO2 and NO2 in photochemical air pollution, symptoms were ascertained using NHLBI questions on 8,572 Southern California Seventh-day Adventist, nonsmokers, 25 years and older, who lived eleven years or longer in their 1977 residential area. Tobacco smoke, active and passive, and occupational exposures were measured by questionnaires, as well as lifestyle characteristics relative to pollution exposure such as time spent outside and residence history. A pulmonary function feasibility study was done on a subsample of 86 women 50-64 years of age …

Sources Of Nosocomial Infections In Immunocompromised Patients (Letter), B. Burt Gerstman

Faculty Publications

No abstract provided.

The Effect Of Nursing Discharge Counseling Sessions On The Pre-Discharge Anxiety Level Of The Neurotically-Depressed Female In A Community Hospital Setting, Deborah Snyder Galasso

Loma Linda University Electronic Theses, Dissertations & Projects

Discharge from the hospital has been identified as a time when patients are in need of additional nursing support. The prospect of leaving the protective hospital environment to return to the home environment with its life stresses can cause anxiety. This study was designed to test the effect of a nursing intervention, discharge counseling sessions, on the anxiety level of the neurotically-depressed female prior to discharge.

The null hypothesis guiding this study was: nursing discharge counseling sessions will have no significant (α=0.05) effect on the pre-discharge anxiety level of the neurotically-depressed female in a community hospital setting. The State-Trait Anxiety …

The Effect Of Post-Hospital Nursing Intervention On Success In Breastfeeding, Melinda Hoskins

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to compare the proportion of women in the experimental group who had a successful breastfeeding experience following post-discharge nursing intervention with the proportion of women in the control group who had a successful breastfeeding experience without nursing intervention. Criteria defining success in breastfeeding were established before the study. Chi-square analysis was used to test for significance with the preset level of significance being α = 0.05. The sample comprised 25 mother-infant dyads with 12 in the experimental group and 13 in the control group. Both groups were similar in type of delivery (spontaneous or …

Relationship Between Some Demographic Characteristics And Adverse Reactions Experienced By Women Undergoing A Therapeutic Abortion While Awake, Karen K. House

Loma Linda University Electronic Theses, Dissertations & Projects

With the liberalization of abortion laws by the Supreme Court in 1973, American women have been able to obtain therapeutic abortions in hospitals and out-patient clinics in ever increasing numbers. With the increased number of women seeking abortions the medical field has responded with abortion procedures that are safe and relatively quick. With the speed doctors use to perform the procedure, many women may wish to take advantage of the medically safer method of abortion under local anesthesia. However, some women are unable to withstand the psychological and physical stress associated with a therapeutic abortion while awake. It would be …

A Descriptive Study Of Women's Attitudes Towards Obtaining Or Not Obtaining Papanicolaou Smears, Linda J. Shults

Loma Linda University Electronic Theses, Dissertations & Projects

It was the purpose of this study to identify the attitudes of a selected group of women which influenced their participation in Papanicolaou testing. These attitudes were inferred from the reasons women gave for obtaining the test. The subjects were randomly selected from the telephone book of a medium-sized town in Southern California. The 135 women who participated in the telephone interview were considered to be the respondents in the study.

A review of the literature revealed that through the annual use of the Papanicolaou smear, approximately 11,000 deaths every year from uterine and cervical cancer could be prevented, Attitudes …

Exploration Of The Incidence Of Identified Emotional Disorders In Selected General Hospitals Of Nebraska, Arlene M. Van Horn

Loma Linda University Electronic Theses, Dissertations & Projects

A descriptive-comparative survey using content analysis of medical records has been done to determine the frequency with which emotional disorders are identified by medical personnel in the population hospitalized in small general hospitals in north-central Nebraska.

A systematic, random sample of medical records was taken from two hospitals arbitrarily included in the study on the basis of bed capacity and distance from mental health facilities.

Each medical record that was reviewed has been placed in a category based on whether an emotional disorder was identified in it by the medical personnel, or whether it contained recorded behaviors that could indicate …

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

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

Using A Participating Relationship To Improve Teen-Age Unwed Mother's Self-Esteem, Linda Gail Reeves

Loma Linda University Electronic Theses, Dissertations & Projects

The study was to provide an approach to help teen-age unwed mothers increase their feelings of self-esteem and thereby attain a conceptual buffer for better coping with life. Self-esteem was defined as individual perception of the worth of oneself relative to that of significant others. The hypothesis tested was that the participating relationship a community health nurse has with a teen-age unwed mother will significantly increase the mother's self-esteem as measured by statistical Q-Sort analysis.

A convenience sample of twenty teen-age unwed mothers was obtained from referrals from San Bernardino County Health, Welfare, and Probation Departments. The girls were between …

Depression And Uncooperativeness In Public Health Patients, P. Sherrill Baugher, Nancy Lynn Swan

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine whether uncooperative behavior and a quantitative measurement of depression exist in the same patient in a public health nurse's caseload. Seven full-time public health nurses were randomly selected from the San Bernardino Public Health Department staff. They reviewed their caseloads and selected all the patients who met the general criteria.

Patients were then classified as cooperative or uncooperative based on the following specific criteria: (1) gives unreliable information, (2) uses the nurse as a "buffer" between helping agencies, (3) demands immediate gratification of requests in a stressful situation, (4) makes only token …

The Preparation Of Nursing Care Guides From A Study Of Nursing Problems In African Rural Hospitals, Edith L. Gillham

Loma Linda University Electronic Theses, Dissertations & Projects

This study was conducted to make nursing care guides which can be used by African students of nursing in making individualized nursing care plans. The nursing problems which were met in African rural hospitals served as a basis for the nursing care guides. Data for the study were obtained through questionnaires which were airmail to ten rural hospitals in Africa. Eight of the hospitals responded to the questionnaires.

The types of employees, the hospital facilities, and diseases of patients hospitalized during 1963 were studied. Special emphasis was placed upon the nursing problems found in the hospitals. These items were employed …