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Articles 10771 - 10800 of 13368
Full-Text Articles in Entire DC Network
Adjusting Wheal Size Measures To Correct Atopy Misclassification, Hongmei Zhang, Wilfried J. Karmaus, Jianjun Gan, Weichao Bao, Yan D. Zhao, Dewi Rahardja, John W. Holloway, Martha Scott, Syed Hasan Arshad
Adjusting Wheal Size Measures To Correct Atopy Misclassification, Hongmei Zhang, Wilfried J. Karmaus, Jianjun Gan, Weichao Bao, Yan D. Zhao, Dewi Rahardja, John W. Holloway, Martha Scott, Syed Hasan Arshad
Faculty Publications
Purpose: Skin prick testing (SPT) is fundamental to the practice of clinical allergy identifying relevant allergens and predicting the clinical expression of disease. Wheal sizes on SPT are used to identify atopic cases, and the cut-off value for a positive test is commonly set at 3 mm. However, the measured wheal sizes do not solely reflect the magnitude of skin reaction to allergens, but also skin reactivity (reflected in the size of histamine reaction) and other random or non-random factors. We sought to estimate wheal sizes exclusively due to skin response to allergens and propose gender-specific cutoff points of atopy. …
Groundwater Uranium And Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Matteo Bottai, Robin C. Puett, Dwayne E. Porter, Susan Bolick-Aldrich, Tom Temples, Rebecca C. Wilkerson, John E. Vena, James R. Hébert
Groundwater Uranium And Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Matteo Bottai, Robin C. Puett, Dwayne E. Porter, Susan Bolick-Aldrich, Tom Temples, Rebecca C. Wilkerson, John E. Vena, James R. Hébert
Faculty Publications
Objective
This ecologic study tested the hypothesis that census tracts with elevated groundwater uranium and more frequent groundwater use have increased cancer incidence.
Methods
Data sources included: incident total, leukemia, prostate, breast, colorectal, lung, kidney, and bladder cancers (1996–2005, SC Central Cancer Registry); demographic and groundwater use (1990 US Census); and groundwater uranium concentrations (n = 4,600, from existing federal and state databases). Kriging was used to predict average uranium concentrations within tracts. The relationship between uranium and standardized cancer incidence ratios was modeled among tracts with substantial groundwater use via linear or semiparametric regression, with and without stratification …
Alcohol Consumption And Risk Of All-Cause And Cardiovascular Disease Mortality In Men, Erin K. Howie, Xuemei Sui, Duck-Chul Lee, Steven P. Hooker, James R. Hébert, Steven N. Blair
Alcohol Consumption And Risk Of All-Cause And Cardiovascular Disease Mortality In Men, Erin K. Howie, Xuemei Sui, Duck-Chul Lee, Steven P. Hooker, James R. Hébert, Steven N. Blair
Faculty Publications
This study examined the association between consumption of alcoholic beverages and all-cause and cardiovascular disease (CVD) mortality in a cohort of men (n = 31,367). In the Cox proportional hazards model adjusted for age, year of examination, body mass index (BMI), smoking, family history of CVD, and aerobic fitness, there were no significant differences in risk of all-cause mortality across alcohol intake groups. Risk of CVD mortality was reduced 29% in quartile 1 (HR = 0.71, 95% confidence interval (CI): 0.53, 0.95) and 25% in quartile 2 (HR = 0.75, 95% CI: 0.58, 0.98). The amount of alcohol consumed …
The Relationship Between Sunlight And Cerebrovascular Health, Shia T. Kent
The Relationship Between Sunlight And Cerebrovascular Health, Shia T. Kent
All ETDs from UAB
Sunlight radiation may be related to stroke risk through increased vitamin D production. The latter has been associated with a number of conditions including stroke, cognitive function and cardiovascular disease. We performed three sets of analyses to determine whether higher levels of sunlight radiation were associated with lower rates of stroke incidence, all-cause mortality, and cognitive decline. We explored these relationships using the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national longitudinal cohort of 30,239 participants. We merged the participants' residential histories with a ground and satellite-derived NASA dataset to characterize 15-year average sunlight radiation and …
A Cluster Analysis Based On The Health Belief Model Of Alacare Patients At High Risk For Osteoporosis, Elizabeth M. Kitchin
A Cluster Analysis Based On The Health Belief Model Of Alacare Patients At High Risk For Osteoporosis, Elizabeth M. Kitchin
All ETDs from UAB
The prevalence of osteoporosis and subsequent fragility fractures will continue to rise as the American population ages. The high personal and medical costs of fragility fractures have been well documented. Taking calcium and vitamin D supplements are important strategies for lowering the risk of sustaining a fragility fracture and for improving the efficacy of prescription osteoporosis medications. The purpose of this study was to determine if patients in a home health setting in Alabama (Alacare) who are defined as high risk for a fragility fracture could be segmented via cluster analysis based on the constructs of the Osteoporosis Health Belief …
Factors Associated With Prescribing Antiviral Medications For Treatment Of Influenza Among Primary Care Physicians In The United States, Payal Patel
All ETDs from UAB
Influenza is a contagious respiratory illness that affects millions each year. The illness, if not contained, can be a paramount public health threat in the U.S. and the world. Primary care physicians play an essential role in administering antiviral medications as a treatment for influenza yet the factors that influence their prescribing of these medications remain unclear. The present study aims to identify factors associated with physicians' prescribing of antiviral medications in the ambulatory care setting. The data utilized for this study were obtained from the National Ambulatory Medical Care Survey for each influenza season between the years of 2005-2008. …
Survival Analysis With Censored Outcomes, Henry T. Robertson
Survival Analysis With Censored Outcomes, Henry T. Robertson
All ETDs from UAB
This dissertation is arranged in the three-paper format. The unifying theme of the dissertation is estimating longevity in terms of years of life lost (YLL). The papers are presented in order of increasing methodological focus. The first paper, No compelling evidence that sibutramine prolongs life in rodents despite providing a dose-dependent reduction in body weight, was published in the International Journal of Obesity in 2010. Although sibutramine reduced food intake and body weight, it had no association with longevity. The conclusions were based on data from a 2-year toxicology trial required by the FDA. Although this paper was largely applied …
Three Topics In Eye Injury Research, Justin Blackburn
Three Topics In Eye Injury Research, Justin Blackburn
All ETDs from UAB
Eye injuries are a leading cause of monocular blindness, with approximately 2 million Americans sustaining an eye injury annually. Occupational eye injuries resulting in at least one missed day of work total nearly 28,000 each year. Eye injuries have many different etiologies, although most are "minor" injuries such as corneal abrasions and foreign bodies. Chemical-related eye injuries have not been described epidemiologically. The most widely advocated prevention method for eye injuries is protective eyewear, but evidence to support this is surprisingly absent. Furthermore, the use of eye protection among workers who have previously sustained an eye injury remains a question …
Experimental Determination Of Shielding Requirements For Pet Medical Facilities, Bradley Scott Brinkley
Experimental Determination Of Shielding Requirements For Pet Medical Facilities, Bradley Scott Brinkley
All ETDs from UAB
Purpose: Shielding considerations are important for designing a positron emission tomography/computed tomography (PET/CT) imaging facility, because of the high energy (511 keV) of electron-positron annihilation photons. Since radiation emitted from patients administered PET radiopharmaceuticals includes lower-energy scattered photons, a given thickness of lead attenuates more of the radiation than it would for a monoenergetic beam of 511 keV photons. A more accurate determination of the effective attenuation coefficient of lead for the spectra of photon energies emitted from PET/CT patients could reduce the shielding requirements necessary to adequately protect public health. In this work, the spectra of energies emitted from …
Statistical Methods In The Analysis Of Copy Number Variation Data, Nathan Wineinger
Statistical Methods In The Analysis Of Copy Number Variation Data, Nathan Wineinger
All ETDs from UAB
Copy number variation is a significant form of genetic variation that has been shown to influence many traits. However, current methods used to estimate copy number variation are imprecise and prone to errors. This property is demonstrated in a study examining copy number variation in African Americans recruited into the Hypertensive Genetic Epidemiology Network study, and who were genotyped on the Affymetrix 6.0 array. The effect this has on downstream association analyses is explored, an alternative methods are proposed. Finally, a method is proposed that uses linkage disequilibrium between copy number variants and single nucleotide polymorphisms to improve the accuracy …
The Effect Of Changes In Tort Laws On Cesarean Section Rates In The United States, Allison Jean Taylor
The Effect Of Changes In Tort Laws On Cesarean Section Rates In The United States, Allison Jean Taylor
All ETDs from UAB
"Defensive medicine", medical practice decisions based on fear of malpractice litigation and where risks may outweigh health and cost benefits, is a proposed contributor to increasing cesarean rates in the U.S. Some studies suggest that changes in laws governing medical malpractice actions may decrease the cesarean rate by relieving pressures driving defensive medicine. This study examined whether, in states that have adopted certain tort reform measures, the probability of having a cesarean delivery is lower following implementation of the reform measures. A database of state legislation and court decisions and National Center for Health Statistics natality data files (1991-2004) were …
Validation Of The Usf Safe Exposure Time Equation For Heat Stress, Arden Bruce Andersen
Validation Of The Usf Safe Exposure Time Equation For Heat Stress, Arden Bruce Andersen
USF Tampa Graduate Theses and Dissertations
Heat stress conditions are prevalent in the working environment around the world. Often they are not readily engineered out. Administrative controls and, in extreme/toxic environments, personal protective gear are the means available to protect workers. For every combination of metabolic work rate, clothing ensemble and environmental WBGT, there is a time of exposure threshold, beyond which the worker can no longer compensate for the heat stress, and signs and symptoms of heat strain appear. Increasingly, worker environments require specialty clothing either for worker protection or to maintain a clean/sanitary environment. Prior to the publication of the USF safe exposure time …
Impact Of A Wellness Clinic Visit On Cardiovascular Risk Biomarkers In Employees Of A Va Medical Center, Margaret Asomaning
Impact Of A Wellness Clinic Visit On Cardiovascular Risk Biomarkers In Employees Of A Va Medical Center, Margaret Asomaning
USF Tampa Graduate Theses and Dissertations
Background: Worksite screening programs are increasingly being provided by employers as a means to reduce cardiovascular risk in employees. A screening program that consists of fasting serum analysis of glucose plus a lipid panel is offered yearly to employees at the VA medical center in Tampa. A retrospective study was conducted to determine if a wellness clinic exposure resulted in significant changes in employees' markers of cardiovascular risk.
Methods: Computerized records were used to follow serial outcomes for glucose, triglycerides, HDL cholesterol, and LDL cholesterol in employees whose screening results showed abnormal levels of one or more of …
Detection Of Polybrominated Diphenyl Ethers In Ambient Air At A Wastewater Treatment Facility In Tampa, Florida, Brenda L. White
Detection Of Polybrominated Diphenyl Ethers In Ambient Air At A Wastewater Treatment Facility In Tampa, Florida, Brenda L. White
USF Tampa Graduate Theses and Dissertations
The goal of this study was to quantify the ambient air concentrations of polybrominated diphenyl ethers (PBDEs) from three locations within the Howard Curren Wastewater Treatment Facility located in Tampa, Florida. PBDEs have been linked to endocrine disruption, cancer, developmental concerns in children, as well as other toxic effects; however their precise roles concerning these deleterious effects remains to be determined. The present study was motivated by these potential health concerns posed by inhalational exposure to PBDEs. Ambient air was monitored with a Tisch Environmental PUF high volume sampler for 48 hours with collection on three types of media-quarts filter, …
Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace
Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Heat Stress Levels, Brian Grace
USF Tampa Graduate Theses and Dissertations
Clothing can influence heat stress depending on the design and its ability to act as a barrier. The progressive heat stress protocol permitted the collection of data to empirically estimate the apparent total evaporative resistance (Re,T,a). Five different clothing ensembles were evaluated, which included work clothes, cotton coveralls, and three limited-use protective clothing ensembles including a pthesis-barrier ensemble, (Tyvek® 1424), water-barrier, vapor-permeable ensemble (NexGen® LS 417), and a vapor-barrier ensemble (Tychem QC®). The study design called for three metabolic level's: low, moderate, and high (L, M, & H) and three heat stages: compensable, transitional, …
An Evaluation Of The Early Steps Referral Process In Hillsborough County To Detect Delays In Access To Early Intervention Services, Jessica Fry Johnson
An Evaluation Of The Early Steps Referral Process In Hillsborough County To Detect Delays In Access To Early Intervention Services, Jessica Fry Johnson
USF Tampa Graduate Theses and Dissertations
Early intervention services are important in obtaining better outcomes for infants with a developmental delay or a condition that may result in a delay. In Florida, a primary resource for providing these services is the Early Steps Program. This study analyzed the Early Steps referral process to identify barriers to prompt access. The guiding hypothesis was if differences exist in key outcomes of the referral process, then these differences may reveal where improvements can be made. Improving access to early intervention should produce better outcomes and reduce the costs of services required later by addressing developmental concerns earlier.
The dataset …
Performance Assessment Of Predicted Heat Strain In High Heat Stress, Ronald Eugene Long
Performance Assessment Of Predicted Heat Strain In High Heat Stress, Ronald Eugene Long
USF Tampa Graduate Theses and Dissertations
Heat stress is a common physical agent associated with many occupations. The most commonly used method of assessing heat stress exposure is an empirical method using the Wet Bulb Globe Temperature Index but his method is limited in its ability to parse out individual contributors to the heat stress. The International Organization for Standardization (ISO) published a rational model called Predicted Heat Strain (PHS) in 2004, and rational methods have the advantage of separating out the individual pathways for heat exchange. The objective of this research was a performance assessment of the current PHS model. This experimental design consisted of …
Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo
Numeracy, Cancer Risk Perceptions, And Self-Protective Behaviors Among U.S. Adults, Teri Malo
USF Tampa Graduate Theses and Dissertations
Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which …
Barbershop Communications On Prostate Cancer Screening Using Barber Health Advisers, John S. Luque, Brian M. Rivers, Clement K. Gwede, Maisha Kambon, B. Lee Green, Cathy D. Meade
Barbershop Communications On Prostate Cancer Screening Using Barber Health Advisers, John S. Luque, Brian M. Rivers, Clement K. Gwede, Maisha Kambon, B. Lee Green, Cathy D. Meade
Community Health: Faculty Publications
Objective: The authors report the outcomes of a community-based, barber health adviser pilot intervention that aims to develop customized educational materials to promote knowledge and awareness of prostate cancer (CaP) and informed decision making about prostate cancer screening (PCS) among a predominantly African American clientele.
Method: First, the authors implemented a series of learner verification processes with barbershop clients (n=15) to adapt existing CaP health promotion materials. Following intervention implementation in the barbershop, they conducted structured surveys with barbershop clients (n=40) to evaluate the intervention. Results: Findings from the posttest showed both a significant increase in barbershop clients' …
Salud Es Vida: Development Of A Cervical Cancer Education Curriculum For Promotora Outreach With Latina Farmworkers In Rural Southern Georgia, Kristen J. Wells, John S. Luque, Branko Miladinovic, Natalia Vargas, Yasmin Asvat, Richard G. Roetzheim, Ambuj Kumar
Salud Es Vida: Development Of A Cervical Cancer Education Curriculum For Promotora Outreach With Latina Farmworkers In Rural Southern Georgia, Kristen J. Wells, John S. Luque, Branko Miladinovic, Natalia Vargas, Yasmin Asvat, Richard G. Roetzheim, Ambuj Kumar
Community Health: Faculty Publications
Methods: A systematic review was conducted to synthesize evidence from all prospective controlled studies on effectiveness of CHW programs in improving screening mammography rates. Studies reported in English and conducted in the United States were included if they: (i) evaluated a CHW intervention designed to increase screening mammography rates in women 40 years of age or older without a history of breast cancer; (ii) were a randomized controlled trial (RCT), case-controlled study, or quasi-experimental study; and (iii) evaluated a CHW intervention outside of a hospital setting.
Results: Participation in a CHW intervention was associated with a statistically significant …
Comparison Of Road Safety Behaviour Of Rented Dublin Bike Users With That Of Owner Cyclists, Eileen Deegan
Comparison Of Road Safety Behaviour Of Rented Dublin Bike Users With That Of Owner Cyclists, Eileen Deegan
Students Learning with Communities
Cycling is a unique way of travelling and exercising. The Irish Heart Foundation recommends thirty minutes of exercise most days in the week to maintain a healthy heart (IHF, 2008). The introduction of the Dublin-bike scheme by Dublin city Council in connection with JCDecaux on the 13th of September 2009 has encouraged and allowed more people to cycle around the city of Dublin. Since their introduction, Dublin-bikes have grown rapidly in popularity. By the 31st of December 2009 24,016 people had subscribed to the scheme (Dublin City Council, 2009). On the 16th of August 2010, The Irish Times published that …
Cerebral Perfusion In Chronic Stroke: Implications For Lesion-Symptom Mapping And Functional Mri, Jessica D. Richardson, Julie M. Baker, Paul S. Morgan, Chris Rorden, L. Bonilha, Julius Fridriksson
Cerebral Perfusion In Chronic Stroke: Implications For Lesion-Symptom Mapping And Functional Mri, Jessica D. Richardson, Julie M. Baker, Paul S. Morgan, Chris Rorden, L. Bonilha, Julius Fridriksson
Faculty Publications
Lesion-symptom mapping studies are based upon the assumption that behavioral impairments are directly related to structural brain damage. Given what is known about the relationship between perfusion deficits and impairment in acute stroke, attributing specific behavioral impairments to localized brain damage leaves room for speculation, as impairments could also reflect abnormal neurovascular function in brain regions that appear structurally intact on traditional CT and MRI scans. Compared to acute stroke, the understanding of cerebral perfusion in chronic stroke is far less clear. Utilizing arterial spin labeling (ASL) MRI, we examined perfusion in 17 patients with chronic left hemisphere stroke. The …
Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman
Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman
Psychology Faculty Articles and Research
Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.
Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …
A Sibling Case-Control Study Of Maternal Prenatal Body Mass Index As A Risk Factor For Autism Spectrum Disorder, Ruth Ann Hendrix
A Sibling Case-Control Study Of Maternal Prenatal Body Mass Index As A Risk Factor For Autism Spectrum Disorder, Ruth Ann Hendrix
Walden Dissertations and Doctoral Studies
The prevalence of autism spectrum disorder (ASD) is estimated to be one in every 150 births. While both genetic and postpartum environmental exposure have been linked to ASD, prenatal maternal weight has not been investigated. The objective of the study is to assess whether overweight or obesity at pregnancy is an important risk factor for the diagnosis of ASD in offspring. A case-control study was designed to answer this question using the public health ecosocial theory. The study population consisted of 70 mothers, who were recruited via the Internet using the viral expansion loop. Multiple logistic regression analysis was used …
Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche
Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche
Walden Dissertations and Doctoral Studies
More people in the United States are approaching retirement age, a trend which has resulted in increased study on life satisfaction and psychological well-being of the elderly. Previous researchers have focused on the relationship between religious social support and life satisfaction; however, there remains a gap in the literature regarding how race and gender may influence this association. Knowledge of interactions between religiosity, gender, and race will enable counselors working with different groups of religiously inclined clients to develop and implement religious-based interventions specific to their clients. Guided by the social ecological model, the purpose of this study was to …
Educational Stakeholders' Perspectives On School-Based Obesity Prevention Programs, Todd Yatchyshyn
Educational Stakeholders' Perspectives On School-Based Obesity Prevention Programs, Todd Yatchyshyn
Walden Dissertations and Doctoral Studies
Childhood obesity is a worldwide problem that can lead to adverse health conditions. In several rural Pennsylvania communities, over one third of elementary students are characterized as overweight, having a body mass index above the 85th percentile. The purpose of the study was to investigate educational stakeholders' perspectives about school-based obesity-prevention programs. The conceptual framework focused on cognitive theory, the theory of planned behavior, and the trans-theoretical model of health behavior change, which postulates that an individual's readiness to change is the most important factor of intervention programs. Qualitative interview data were gathered from 18 educational stakeholders. Inductive code-based analysis …
Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards, Salma Theus
Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards, Salma Theus
Walden Dissertations and Doctoral Studies
U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness Test, the General Self-Efficacy Scale, the Stress Management Questionnaire, the Lifestyle Assessment Inventory, and the Multifactor Leadership Questionnaire. Multiple regression analysis was used to determine if personal (intellectual capabilities and physical fitness), behavioral (lifestyle and stress management), and/or environmental (supervisor leadership) factors predict self-efficacy and …
Discrete Trial Instruction: Comparing The Abbreviated Performance Feedback And Lecture Test Models, Tammy J. Dobbs
Discrete Trial Instruction: Comparing The Abbreviated Performance Feedback And Lecture Test Models, Tammy J. Dobbs
Walden Dissertations and Doctoral Studies
Growing media attention and a high diagnosis rate of autism places significant demand on the service industry to provide qualified staff to work with individuals who have autism. Discrete trial instruction (DTI) is one of the most sought-after treatment approaches for those individuals. However, there is a gap in research regarding the efficacy of training methods for those who train direct staff to implement DTI. This quantitative study used an applied behavior analysis basis, deriving from foundations of behavior theory, to compare the abbreviated feedback form (AFF) to the lecture test model (LTM) to understand which will improve direct staff's …
The Role Of Leadership In Safety Performance And Results, Halina E. Caravello
The Role Of Leadership In Safety Performance And Results, Halina E. Caravello
Walden Dissertations and Doctoral Studies
Employee injury rates in U.S. land-based operations in the energy industry are 2 to 3 times higher relative to other regions in the world. Although a rich literature exists on drivers of safety performance, no previous studies investigated factors influencing this elevated rate. Leadership has been identified as a key contributor to safety outcomes and this grounded theory study drew upon the full range leadership model, situational leadership, and leader-member exchange theories for the conceptual framework. Leadership aspects influencing safety performance were investigated through guided interviews of 27 study participants; data analyses included open and axial coding, and constant comparisons …
The Effectiveness Of Exercise And Nutritional Counseling On Decreasing Body Composition And Increasing Fitness Levels In Firefighters, Michelle R. Mcnear
The Effectiveness Of Exercise And Nutritional Counseling On Decreasing Body Composition And Increasing Fitness Levels In Firefighters, Michelle R. Mcnear
Walden Dissertations and Doctoral Studies
Cardiovascular disease is the leading cause of death in the United States; firefighters are at a greater risk for both the disease and death. Their exposure to stress, toxic fumes and smoke, unhealthy eating habits, excessive weight, and low levels of physical activity are all contributing risk factors to this disease. The purpose of this quantitative study was to determine the effectiveness of a multi-faceted program of exercise and nutritional counseling to decrease body fat composition and increase fitness levels nine months after initial implementation among a sample of 202 firefighters. Social learning theory was the theoretical foundation for the …