Vital and Health Statistics Commons^™

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 …

Academic Predictors Of National Council Licensure Examination For Registered Nurses Pass Rates, Maybeth J. Elliott

Walden Dissertations and Doctoral Studies

The United States continues to be affected by a severe, long-standing nursing shortage that is not projected to resolve within the next 10 or more years. Unsuccessful passage of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) among graduate nurses remains one of several key contributors to the nursing shortage. The goal of this study was to identify if either cumulative fall semester GPA; the overall prenursing science, mathematics, and English GPA; type of high school background; TOEFL score; clinical pass or fail; and on-time program completion best predicted passage of NCLEX-RN. Archived records from the academic years of …

The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira

UNLV Theses, Dissertations, Professional Papers, and Capstones

Different population groups across Nevada and throughout the United States suffer disproportionately from colorectal cancer and its after-effects. Overcoming cancer health disparities is important for lessening the burden of cancer. There has been an overall decline in the incidence of and mortality from colorectal cancer (CRC). This is likely due, in part, to the increasing use of screening procedures such as Fecal Occult Blood Test (FOBT) and/or endoscopy, which can reduce the risk of CRC mortality by fifty percent. Nevertheless, screening procedures are routinely used by only fifty percent of Americans aged fifty years and older. Despite overall mortality decreasing …

Culturally-Adapted And Audio-Technology Assisted Hiv/Aids Awareness And Education Program In Rural Nigeria: A Cohort Study, Ighovwerha Ofotokun, Jose Nilo G. Binongo, Eli S. Rosenberg, Michael Kane, Rick Ifland, Jeffrey L. Lennox, Kirk A. Easley

Faculty Articles

Background: HIV-awareness programs tailored toward the needs of rural communities are needed. We sought to quantify change in HIV knowledge in three rural Nigerian villages following an integrated culturally adapted and technology assisted educational intervention.

Methods: A prospective 14-week cohort study was designed to compare short-term changes in HIV knowledge between seminar-based education program and a novel program, which capitalized on the rural culture of small-group oral learning and was delivered by portable digital-audio technology.

Results: Participants were mostly Moslem (99%), male (53.5%), with no formal education (55%). Baseline HIV knowledge was low (< 80% correct answers for 9 of the 10 questions). Knowledge gain was higher (p < 0.0001 for 8 of 10 questions) in the integrated culturally adapted and technology-facilitated (n = 511) compared with the seminar-based (n = 474) program.

Conclusions: Baseline HIV-awareness was low. Culturally …

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, …

The Association Of Maternal Intention To Breastfeed, Early Skin-To-Skin Mother/Infant Contact, And Exclusive Breastfeeding During The Maternity Hospital Stay, Leslie Mary Bramson

Loma Linda University Electronic Theses, Dissertations & Projects

Breastfeeding is the optimal method to nourish and nurture an infant. Exclusive breastfeeding rates in the United States have reached the goal of Healthy People 2010 that 75% of mother's breastfeed in the immediate postpartum period. Yet, less than 35% of San Bernardino county mothers and 47.7% of Riverside county mothers are exclusively breastfeeding during their maternity hospital stays, with as many as 50% of the infants being weaned from the breast in the first 14 days of life.

This prospective study examined archived data collected by Perinatal Services Network (PSN) of Loma Linda University Medical Center/Children's Hospital for the …

The Impact Of Being Born With Cleft And Cleft Reparative Surgery On Overall Health And Speech Outcomes, Khatansuudal Evsanaa

Master's Theses

Orofacial cleft is one of the most common and treatable birth defects in the world. If left untreated, orofacial cleft can impair normal speech development, growth, and could lead to a number of health consequences later in life. The main motivation of the study is to measure the impact of being born with cleft and the cleft reparative surgery on overall speech and health cleft for teenagers in India using difference-in-differences approach along with household fixed effects method. An overall health outcome was measured using height, weight, grip strength and BMI, and the speech acceptability was measured using a “Universal …

A Comparison Of Different Methods For Predicting Cancer Mortality Counts At The State Level, Corinne Wilson

Virginia Journal of Science

Cancer is a major health issue in the United States. Reliable estimates of yearly cancer mortality counts are essential for resourcing and planning. The American Cancer Society has used several methods of forecasting to estimate the future cancer burden and researchers are continually working to develop new methods with improved performance. There have been studies comparing different models for predicting the US cancer mortality counts. This study explores and compares several different models for cancer mortality count predictions at the state level, principally for the state of Virginia. Results of the comparisons appear to show the final improved model to …

Low Birth Weight, Very Low Birth Weight And Infant Mortality In San Bernardino County : A Secondary Analysis Of Maternal Factors, Rebecca D. Nanyonjo

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: National and state infant mortality rates have slowly declined over the last several years. Despite this reduction, San Bernardino County still has one of the highest infant mortality rates in California and racial disparities between Black and White infants not only persist but continue to widen. These disparities remain at the forefront of concern. Healthy People 2010 target objectives have yet to be reached, while national and state proposed plans have supported the statement that a community's largest health problem is initiated by its infant mortality. The purpose of this study was to investigate maternal factors through use of …

Different Public Health Interventions Have Varying Effects, Paula Diehr, Anne B. Newman, Liming Cai, Ann Derleth

UW Biostatistics Working Paper Series

Objective: To compare performance of one-time health interventions to those that change the probability of transitioning from one health state to another. Study Design and Setting: We used multi-state life table methods to estimate the impact of eight types of interventions on several outcomes. Results: In a cohort beginning at age 65, curing all the sick persons at baseline would increase life expectancy by 0.23 years and increase years of healthy life by .54 years. An equal amount of improvement could be obtained with a 12% decrease in the probability of getting sick, a 16% increase in the probability of …

Is The Number Of Sick Persons In A Cohort Constant Over Time?, Paula Diehr, Ann Derleth, Anne Newman, Liming Cai

UW Biostatistics Working Paper Series

Objectives: To estimate the number of persons in a cohort who are sick, over time.

Methods: We calculated the number of sick persons in the Cardiovascular Health Study (CHS), a cohort study of older adults followed up to 14 years, using eight definitions of “healthy” and “sick”. We projected the number in each health state over time for a birth cohort.

Results: The number of sick persons in CHS was approximately constant for 14 years, for all definitions of “sick”. The estimated number of sick persons in the birth cohort was approximately constant from ages 55-75, after which it decreased. …

The Outcome Of Mta As A Root End Filling Material: A Long Term Evaluation, Christopher M. Sechrist

Loma Linda University Electronic Theses, Dissertations & Projects

Periradicular surgery is a viable option to save natural teeth when non-surgical treatment fails or when endodontic retreatment is not feasible or contraindicated. Laboratory and animal studies have demonstrated that MTA is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to provide long term (>3 years) clinical evidence for its use as a root-end filling material in endodontics. The clinical records of 294 patients who had MTA used during endodontic treatment from 1996 to 2001 were reviewed. From these, 75 patients whose root end cavities had been filled …

Estimating Percentile-Specific Causal Effects: A Case Study Of Micronutrient Supplementation, Birth Weight, And Infant Mortality, Francesca Dominici, Scott L. Zeger, Giovanni Parmigiani, Joanne Katz, Parul Christian

Johns Hopkins University, Dept. of Biostatistics Working Papers

In developing countries, higher infant mortality is partially caused by poor maternal and fetal nutrition. Clinical trials of micronutrient supplementation are aimed at reducing the risk of infant mortality by increasing birth weight. Because infant mortality is greatest among the low birth weight infants (LBW) (• 2500 grams), an effective intervention may need to increase the birth weight among the smallest babies. Although it has been demonstrated that supplementation increases the birth weight in a trial conducted in Nepal, there is inconclusive evidence that the supplementation improves their survival. It has been hypothesized that a potential benefit of the treatment …

Ranking Usrds Provider-Specific Smrs From 1998-2001, Rongheng Lin, Thomas A. Louis, Susan M. Paddock, Greg Ridgeway

Johns Hopkins University, Dept. of Biostatistics Working Papers

Provider profiling (ranking, "league tables") is prevalent in health services research. Similarly, comparing educational institutions and identifying differentially expressed genes depend on ranking. Effective ranking procedures must be structured by a hierarchical (Bayesian) model and guided by a ranking-specific loss function, however even optimal methods can perform poorly and estimates must be accompanied by uncertainty assessments. We use the 1998-2001 Standardized Mortality Ratio (SMR) data from United States Renal Data System (USRDS) as a platform to identify issues and approaches. Our analyses extend Liu et al. (2004) by combining evidence over multiple years via an AR(1) model; by considering estimates …

Incorporating Death Into Health-Related Variables In Longitudinal Studies, Paula Diehr, Laura Lee Johnson, Donald L. Patrick, Bruce Psaty

UW Biostatistics Working Paper Series

Background: The aging process can be described as the change in health-related variables over time. Unfortunately, simple graphs of available data may be misleading if some people die, since they may confuse patterns of mortality with patterns of change in health. Methods have been proposed to incorporate death into self-rated health (excellent to poor) and the SF-36 profile scores, but not for other variables.

Objectives: (1) To incorporate death into the following variables: ADLs, IADLs, mini-mental state examination, depressive symptoms, body mass index (BMI), blocks walked per week, bed days, hospitalization, systolic blood pressure, and the timed walk. (2) To …

Prevalence Of Various Upper Extremity Disorders In Patients With Carpal Tunnel Syndrome Versus Patients Without Carpal Tunnel Syndrome, Daniel C. Buda

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose: Increasingly larger numbers of patients present with repetitive strain injuries of the upper extremities, especially carpal tunnel syndrome (CTS). A large number of these patients appear to have more than one upper extremity condition. The purpose of this study was to determine the probability that a patient diagnosed with carpal tunnel syndrome will also be diagnosed with other upper extremity and/or cervical spine disorders.

Subjects: A group of 188 subjects diagnosed with carpal tunnel syndrome and a group of 203 subjects without carpal tunnel syndrome were selected through a chart review of patients at Loma Linda …

The Role Of Diet And Physical Activity For Ovarian Cancer Results From The Adventist Health Study, Fatemeh Kiani

Loma Linda University Electronic Theses, Dissertations & Projects

A few aspects of the epidemiology of ovarian cancer are well understood, such as the inverse relationship with parity and oral contraceptive (OC) use. The role of other factors such as the potential influence of diet or physical activity is far from being established. A few studies, however, have been able to identify dietary risk factors for ovarian cancer. In this dissertation, I have conducted two studies that investigate the relationship between dietary factors and physical activity and the three endpoints: 1) nonfatal ovarian cancer (1976-1982; time to diagnosis), 2) fatal ovarian cancer (1976-1988; time to death), and 3) total …

Probabilities Of Transition Among Health States For Older Adults, Paula Diehr, Donald L. Patrick

UW Biostatistics Working Paper Series

Goal: To estimate the probabilities of transition among self-rated health states for older adults, and examine how they vary by age and sex. Methods: We used self-rated health (Excellent, Very Good, Good, Fair, Poor, Dead) collected in two longitudinal studies of older adults (Mean age 75) to estimate the probability of transition in two years. We used the estimates to project future health for selected cohorts.

Findings: These older adults were most likely to be in the same health state 2 years later, but a substantial proportion changed in both directions. Transition probabilities varied by initial health state, age and …

Risk Factors Associated With Infant Mortality Among Very Low Birthweight Infants Of Teenage Mothers In San Bernardino County, C. Letitia Henry

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Typically, infant mortality decreases as maternal age increases in teenagers. In contrast to these national data, San Bernardino County (SBC) experienced a different phenomenon in 1989-1994 among very low birthweight (VLBW) infants. The infant mortality rate (IMR) of VLBW infants born to mothers under 17 years old (283 per 1000 live births) was significantly lower than the IMR of VLBW infants born to mothers between the ages of 17-19 years old (430 per 1000 live births) (p = .02).

Purpose. The purpose of the study was to explain the discrepancy between IMRs of VLBW infants of younger teenage mothers …

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 …

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 …

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 …

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 & …

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 Effect Of Dietary Alpha - Linolenic Acid On Apparent Risk Factors Of Cardiovascular Disease, Kelvin D. Lindbeck

Loma Linda University Electronic Theses, Dissertations & Projects

Eight healthy male lacto-ovo-vegetarian subjects averaging 28.0 ± 3.6 years of age (22 to 53 years) were fed a diet rich in α-linolenic acid (18:3 ω 3) for four weeks. Arterial blood pressure and body weight were recorded each week. Plasma 6-keto-prostaglandin F_1α (6-keto- PGF_1α ), thromboxane B₂ (TXB₂), total cholesterol, triglyceride, and total phospholipid fatty acid composition were analyzed at 0, 2 and 4 weeks.

Systolic blood pressure increased significantly between weeks 0 and 1 (106.5 ± 2.7 mmHg to 114.0 ± 3.7 mmHg; p < 0.003), but decreased to 107.3 t 2.6 mrHg (p < 0.02) at week 2. There was an insignificant increase in both systolic and diastolic blood pressures after four weeks. There was no significant change in either total cholesterol or triglyceride levels during the four weeks.

Plasma 6-keto-PGF_1α levels increased significantly from 60.13 ± …

Models For Estimating Psychiatric Bed Needs, Patricia A. Brenneman

Loma Linda University Electronic Theses, Dissertations & Projects

Inland Counties Comprehensive Health Planning Council wished to estimate the psychiatric bed needs by type (such as state hospitals, board and care homes, etc.) in San Bernardino County from the distributions of patient arrivals and of lengths of stay. A statistical description of the system during 1973 was considered the first step toward estimating future bed needs. A computer simulation model using IBM's programming language General Purpose Simulation System (GPSS) was developed and was found to be unsatisfactory.

Theorems were then developed for a statistical model, seeking to predict future bed needs. The most convenient of these theorems states that …

Selected Factors Related To Ability To Regain Bladder Function Following Indwelling Catheterization, Jongkolnee Padmasiri

Loma Linda University Electronic Theses, Dissertations & Projects

This exploratory retrospective study was designed to evaluate selected factors, including the ability to regain bladder function related to post indwelling urethral catheterization in an acute general hospital population.

The records of 107 patients who met the study criteria became the study population. These patients had three-way urethral catheters, continuous antibacterial irrigation and closed drainage system. Twenty patients died (19 percent) before the catheter was removed. Of the 87 patients who were alive, 37 percent (32 patients) had in-adequate bladder function. Of these 32 patients, no attempt was made to remove the catheter from 15 prior to their hospital discharge. …

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]