Design of Experiments and Sample Surveys Commons^™

"It Makes You Feel Like Someone Cares" Acceptability Of A Financial Incentive Intervention For Hiv Viral Suppression In The Hptn 065 (Tlc-Plus) Study., Elizabeth Greene, Allison Pack, Jill Stanton, Victoria Shelus, Elizabeth E Tolley, Jamilah Taylor, Wafaa M El Sadr, Bernard M Branson, Jason Leider, Natella Rakhmanina, Theresa Gamble

Pediatrics Faculty Publications

BACKGROUND: HPTN 065 (TLC-Plus) evaluated the feasibility and effectiveness of providing quarterly $70 gift card financial incentives to HIV-infected patients on antiretroviral therapy (ART) to encourage ART adherence and viral suppression, and represents the largest study to-date of a financial incentive intervention for HIV viral suppression. A post-trial qualitative substudy was undertaken to examine acceptability of the financial incentives among those receiving and implementing the intervention.

METHODS: Between July and October 2013, semi-structured interviews were conducted with 72 patients and 12 investigators from 14 sites; three focus groups were conducted with 12 staff from 10 sites. Qualitative data collection elicited …

When Is A Randomised Controlled Trial Health Equity Relevant? Development And Validation Of A Conceptual Framework, J. Jull, M. Whitehead, M. Petticrew, E. Kristjansson, D. Gough, Sarah Baird, +Several Additional Authors

Global Health Faculty Publications

Background Randomised controlled trials can provide evidence relevant to assessing the equity impact of an intervention, but such information is often poorly reported. We describe a conceptual framework to identify health equity-relevant randomised trials with the aim of improving the design and reporting of such trials.

Methods An interdisciplinary and international research team engaged in an iterative consensus building process to develop and refine the conceptual framework via face-to-face meetings, teleconferences and email correspondence, including findings from a validation exercise whereby two independent reviewers used the emerging framework to classify a sample of randomised trials.

Results A randomised trial can …

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

The Relationship Between Self-Determination And Client Outcomes Among The Homeless, Samuel M. Hanna

Electronic Theses, Projects, and Dissertations

This paper has attempted to determine if there is a significant relationship between self-determination and client outcomes among the homeless. The study has been based upon the conceptual framework set forth in Self-Determination Theory. The purpose of the study was to explore the relationship between self-determination and client outcomes among the homeless. Using a data collection instrument, based on empirically validated instrumentation, clients from several homeless service providers in the City of San Bernardino were assessed for the level of self-determination and autonomy support they experience within these agencies. Outcome measures included such things as whether the client was going …

Stratified Meta-Analysis To Examine Data Biases In Lung Cancer Studies Of Refinery Workers, Sherman Selix

Yale Day of Data

Petroleum refineries employ a variety of workers who historically experienced different potentials for asbestos exposure depending on job tasks. Associations between petroleum refinery work and lung cancer related to occupational asbestos exposure have been quantified among various locations, corporations, and time periods. To combine the data from several individual refinery studies and examine an overall effect, a systematic review and stratified meta-analysis was employed. Using set search terms among four databases, 112 potential publications were identified, of which 29 qualified for meta-analysis. Risk estimates and confidence intervals were extracted from these publications to construct four separate datasets. Inverse variance weighting …

Strategic Focus On 3r Principles Reveals Major Reductions In The Use Of Animals In Pharmaceutical Toxicity Testing, Elin Törnqvist, Anita Annas, Britta Granath, Elisabeth Jalkesten, Ian Cotgreave, Mattias Öberg

Application of Alternative Methods Collection

The principles of the 3Rs, Replacement, Reduction and Refinement, are being increasingly incorporated into legislations, guidelines and practice of animal experiments in order to safeguard animal welfare. In the present study we have studied the systematic application of 3R principles to toxicological research in the pharmaceutical industry, with particular focus on achieving reductions in animal numbers used in regulatory and investigatory in vivo studies. The work also details major factors influencing these reductions including the conception of ideas, cross-departmental working and acceptance into the work process. Data from 36 reduction projects were collected retrospectively from work between 2006 and 2010. …

A Comparison Of Prenatal Alcohol, Tobacco, And Other Drug Use Between San Luis Obispo County And Ventura County, Dana M. Williamson

Statistics

Prenatal substance abuse is a growing issue in America. It can lead to fetal alcohol spectrum disorder, long term growth, behavior, and executive functioning problems, and creates a predisposition for drug use for the child.

This project summarizes the statistical analyses comparing alcohol, tobacco, and other drug use by pregnant women between San Luis Obispo County and Ventura County. The main goal of these analyses is to determine if there is a difference between San Luis Obispo County and Ventura County. This is an interesting comparison because these counties are neighboring counties, and past data have shown that the rate …

Adaptive Pair-Matching In The Search Trial And Estimation Of The Intervention Effect, Laura Balzer, Maya L. Petersen, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

In randomized trials, pair-matching is an intuitive design strategy to protect study validity and to potentially increase study power. In a common design, candidate units are identified, and their baseline characteristics used to create the best n/2 matched pairs. Within the resulting pairs, the intervention is randomized, and the outcomes measured at the end of follow-up. We consider this design to be adaptive, because the construction of the matched pairs depends on the baseline covariates of all candidate units. As consequence, the observed data cannot be considered as n/2 independent, identically distributed (i.i.d.) pairs of units, as current practice assumes. …

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 …

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 …

Inflammatory Findings On Species Extrapolations: Humans Are Definitely No 70-Kg Mice, Marcel Leist, Thomas Hartung

Validation of Alternative Methods Collection

Modern toxicology has embraced in vitro methods, and major hopes are based on the Omics technologies and systems biology approaches they bring along (Hartung and McBride in ALTEX 28(2):83–93, 2011; Hartung et al. in ALTEX 29(2):119–28, 2012). A culture of stringent validation has been developed for such approaches (Leist et al. in ALTEX 27(4):309–317, 2010; ALTEX 29(4):373–88, 2012a; Toxicol Res 1:8–22, 2012b), while the quality and usefulness of animal experiments have been little scrutinized. A new study (Seok et al. 2013) now shows the low predictivity of animal responses in the field of inflammation. These findings corroborate earlier findings from …

Food For Thought … Mechanistic Validation, Thomas Hartung, Sebastian Hoffman, Martin Stephens

Experimentation Collection

Validation of new approaches in regulatory toxicology is commonly defined as the independent assessment of the reproducibility and relevance (the scientific basis and predictive capacity) of a test for a particular purpose. In large ring trials, the emphasis to date has been mainly on reproducibility and predictive capacity (comparison to the traditional test) with less attention given to the scientific or mechanistic basis. Assessing predictive capacity is difficult for novel approaches (which are based on mechanism), such as pathways of toxicity or the complex networks within the organism (systems toxicology). This is highly relevant for implementing Toxicology for the 21st …

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, …

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 …

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, …

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 …

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 …

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 …

Lot Quality Assurance Sampling (Lqas) And The Mozambique Malaria Indicator Surveys, Caitlin Biedron, Marcello Pagano, Bethany L. Hedt, Albert Kilian, Amy Ratcliffe, Samuel Mabunda, Joseph J. Valadez

Harvard University Biostatistics Working Paper Series

No abstract provided.

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 …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

Anthropometric Parameters Of Under-Five Years Old Children With Different Dietary Habits In Ukambani Region : A Study In Eastern Rural Kenya, Hellen M. Ndiku

Loma Linda University Electronic Theses, Dissertations & Projects

The objective of this descriptive cross sectional study was to assess dietary intake and nutritional status of children under-five years in two rural sites of Eastern Kenya where the staple cereals may differ. A modified rapid, knowledge, practice and coverage (KPC) questionnaire and a 24-hr dietary recall form were used to collect the data. A total of 403 households were surveyed from four randomly selected divisions. This yielded 629 surrogate 24-hr dietary recalls of children < 5 years with 314 from Mwingi district and 315 from Makueni district (49 % boys and 51 % girls).

Statistical analysis was done using SPSS and SAS. Comparison of means was done using t- test and chi square was used for proportions. The 24-hr …

Immediate Loading Of Unsplinted Implants In The Anterior Mandible For Overdentures, Phillip Roe

Loma Linda University Electronic Theses, Dissertations & Projects

In this one-year prospective study, eight completely edentulous patients were selected from the Loma Linda University School of Dentistry (LLUSD) patient population to participate. There were five male and three female patients, between the ages of 58 and 82 (mean age of 69.1 years). All participants received new maxillary and mandibular complete dentures prior to implant placement. Two 4.0 mm x 13 mm threaded implants with a fluoride-modified, micro-roughened, titanium surface were placed mesial to each mandibular canine position. Locator abutments were connected and torqued to 25 Ncm and primary closure was achieved with a nonresorbable suture material. The Locator …

The Prevalence And Determinants Of Health Risk Behaviors Among High School Students In Mexico, Nellie León

Loma Linda University Electronic Theses, Dissertations & Projects

The Centers for Disease Control and Prevention report that despite health promotion efforts, adolescents continue to engage in behaviors that put them at risk for morbidity and mortality. Alcohol consumption, illicit drug use, smoking, and risky sexual behaviors are among the behaviors that contribute to leading causes of morbidity and mortality in youth; these four behaviors were explored in this study. An observational cross-sectional design was utilized. The Youth Risk Behavior Survey from the Centers for Disease Control and Prevention was utilized to assess the prevalence of the four risk behaviors among high school students in Jalisco, Mexico. Items constructed …

Barriers Encountered During Enrollment In An Internet-Mediated Randomized Controlled Trial, Lorraine R. Buis, Adrienne W. Janney, Michael L. Hess, Silas A. Culver, Caroline R. Richardson

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Online technology is a promising resource for conducting clinical research. While the internet may improve a study's reach, as well as the efficiency of data collection, it may also introduce a number of challenges for participants and investigators. The objective of this research was to determine the challenges that potential participants faced during the enrollment phase of a randomized controlled intervention trial of Stepping Up to Health, an internet-mediated walking program that utilized a multi-step online enrollment process.

Methods

We conducted a quantitative content analysis of 623 help tickets logged in a participant management database during the enrollment …

The Comparative Radiopacity Between Primary And Permanent Teeth, Robert C. Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This in vitro study compared the radiopacity between human primary and permanent enamel and dentin. It also compared the radiopacity between human anterior and posterior teeth.

Methods: Extracted primary and permanent teeth were used in this study. One mm enamel and one mm dentin slices were cut from each extracted tooth. Radiographs were taken of each enamel and dentin specimen 1 mm in thickness along with an aluminum step-wedge using procedures specified in International Standards Organization (ISO) 4049:2000. A densitometer was used to measure the Optical Density (OD) of the radiographs of the specimen and the accompanying aluminum step-wedge. …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Salivary Characteristics In 3 And 4 Year-Old Children With And Without Visible Caries, Gloria Yañez

Loma Linda University Electronic Theses, Dissertations & Projects

PURPOSE: To compare salivary characteristics in 3 and 4 year-old Head Start children with and without visible caries.

METHODS: This case-control study was performed on 84 healthy 3 and 4 year-old Head Start children. After consent and inclusion criteria were met, each child was screened and assigned to one of two test groups based on their caries status. Group 1 consisted of children with no visible evidence of caries, although non-visible caries may have been present. Group II consisted of children with visible evidence demonstrating three or more carious lesions. Each child's unstimulated and stimulated whole saliva samples were collected …

The Latino Caregiver Experience Among Dementia And Non-Dementia Caregivers : Can Community Based Care Management Improve Caregiver Health?, Catherine Oliveros

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This study provides an analysis of the Latino caregiving community in Southeast Texas and the role community based care management plays in influencing caregiver physical and emotional well-being. Design and Methods: A non-random sample of 63 Latino caregivers was interviewed by phone. Caregiver physical and emotional well-being was studied through burden, depression, perceived health status, and resourcefulness. Regression, correlation, and comparison analysis was performed with key variables. Results: Acculturation was positively correlated with care management use. In comparing dementia and non-dementia caregivers both groups had similar levels of depression and burden, however, the dementia group had significantly lower levels …

Evaluation Of Program Outcomes: Assessment In Children, Cheryl M. Romano

Loma Linda University Electronic Theses, Dissertations & Projects

In an age of increased concern for accountability and the review of services, administrators of health programs should be able to present their clinics effectiveness, and demonstrate their excellent service to the community, along with providing evidence for the continued need of such clinics. Outcome evaluation plays an integral part in providing this information, and is intended to provide information concerning the effectiveness of a particular program, thus allowing for modification, and even better outcomes.

This project addressed pre and post functioning in children referred for academic and/or behavioral difficulties, in a university of health sciences-based clinic. The aim was …