Medicine and Health Sciences Commons^™

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Neuroimaging And Recovery Of Language In Aphasia, Cynthia K. Thompson, Dirk B. Den Ouden

Faculty Publications

The use of functional neuroimaging techniques has advanced what is known about the neural mechanisms used to support language processing in aphasia resulting from brain damage. This paper highlights recent findings derived from neuroimaging studies focused on neuroplasticity of language networks, the role of the left and right hemispheres in this process, and studies examining how treatment affects the neurobiology of recovery. We point out variability across studies as well as factors related to this variability, and we emphasize challenges that remain for research.

Breast Cancer Fatalism: The Role Of Women's Perceptions Of The Health Care System, Allyson G. Hall, Amal J. Khoury, Ellen D.S. Lopez, Nedra Lisovicz, Amanda Avis-Williams, Amal K. Mitra

Faculty Publications

Cancer fatalism, which can be understood as the belief that cancer is a death sentence, has been found to be a deterrent to preventive cancer screening participation. This study examines factors associated with breast cancer fatalism among women. We analyzed data from a 2003 survey of women 40 years of age. The survey collected information about respondents' knowledge and attitudes regarding breast health. Analyses compared the characteristics of women who reported and those who did not report a fatalistic attitude. Women with a fatalistic attitude were more likely to be African American, to have a family history of breast cancer, …

Does Place Explain Racial Health Disparities? Quantifying The Contribution Of Residential Context To The Black/White Health Gap In The United States, Brian K. Finch, D. Phuong Do, Ricardo Basurto-Davila, Chloe E. Bird, José J. Escarce, Nicole Lurie

Faculty Publications

The persistence of the black health disadvantage has been a puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context - socio-demographic composition, social aspects, and built environment - has been postulated as an additional explanation for racial disparities, but few attempts have …

Weight Regain Is Related To Decreases In Physical Activity During Weight Loss, Xuewen Wang, Mary F. Lyles, Tongjian You, Michael J. Berry, Jack Rejeski, Barbara J. Nicklas

Faculty Publications

Purpose—To examine whether adaptations in physical activity energy expenditure (PAEE) and resting metabolic rate (RMR) during weight loss were associated with future weight regain in overweight/obese, older women.

Research Methods and Procedures—Thirty-four overweight/obese (BMI=25–40 kg/m²), postmenopausal women underwent a 20-week weight loss intervention of hypocaloric diet with (low- or high-intensity) or without treadmill walking (weekly caloric deficit was ~11760 kJ), with a subsequent 12-month follow-up. RMR (via indirect calorimetry), PAEE (by RT3 accelerometer) and body composition (by DXA) were measured before and after intervention. Body weight and self-reported information on physical activity were collected after intervention, …

Breast Cancer Survival Among Economically Disadvantaged Women: The Influences Of Delayed Diagnosis And Treatment On Mortality, Emily Rose Smith, Swann Arp Adams, Irene Prabhu Das, Matteo Bottai, Jeanette Fulton, James R. Hébert

Faculty Publications

Breast cancer affects thousands each year in the United States, and disproportionately affects certain subgroups. For example, the incidence of breast cancer in South Carolina is lower in African American compared with European American women by ~12% to 15%, but their mortality rate is twice as high as in European American women. The purpose of the study was to assess factors associated with breast cancer mortality between African American and European American women. Participants (n = 314) in South Carolina's Breast and Cervical Cancer Early Detection Program (SCBCCEDP), which provides breast cancer screening and treatment services, during the years …

The Community-Driven Approach To Environmental Exposures: How A Community-Based Participatory Research Program Analyzing Impacts Of Environmental Exposure On Lupus Led To A Toxic Site Cleanup, Julien A. Terrell, Edith M. Williams, Christine M. Murekeyisoni, Robert Watkins, Laurene Tumiel-Berhalter

Faculty Publications

Community-based participatory research (CBPR) is a mechanism to improve environmental quality in communities primarily inhabited by minorities or low income families. A collaborative partnership between the University at Buffalo and the Toxic Waste Lupus Coalition was formed to investigate the high prevalence of lupus in the area and whether cases of disease were linked to chemicals found at a nearby New York State Superfund site in East Buffalo. The purpose of the study was to use CBPR practices to educate impacted residents and enable their participation in efforts to get a nearby contaminated waste site remediated. Community members were active …

Light-Dependant Biostabilisation Of Sediments By Stromatolite Assemblages, David M. Paterson, Rebecca J. Aspden, Pieter T. Visscher, Mireille Consalvey, Miriam S. Andres, Alan W. Decho, John F. Stolz, R. Pamela Reid

Faculty Publications

For the first time we have investigated the natural ecosystem engineering capacity of stromatolitic microbial assemblages. Stromatolites are laminated sedimentary structures formed by microbial activity and are considered to have dominated the shallows of the Precambrian oceans. Their fossilised remains are the most ancient unambiguous record of early life on earth. Stromatolites can therefore be considered as the first recognisable ecosystems on the planet. However, while many discussions have taken place over their structure and form, we have very little information on their functional ecology and how such assemblages persisted despite strong eternal forcing from wind and waves. The capture …

Gender Differences In The Risk Of Hiv Infection Among Persons Reporting Abstinence, Monogamy, And Multiple Sexual Partners In Northern Tanzania, Keren Z. Landman, Jan Ostermann, John A. Crump, Anna Mgonja, Meghan K. Mayhood, Dafrosa K. Itemba, Alison C. Tribble, Evaline M. Ndosi, Helen Y. Chu, John F. Shao, John A. Bartlett, Nathan M. Thielman

Faculty Publications

Background: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania.

Methodology/ Principal Findings: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by …

Exposure To Smoking Imagery In Popular Films And Adolescent Smoking In Mexico, James F. Thrasher, Christine Jackson, Edna Arillo-Santillán, James D. Sargent

Faculty Publications

Background: Exposure to smoking imagery in films in consistently associated with smoking behavior and its psychological antecedents among adolescents in high-income countries, but its association with adolescent smoking in middle-income countries is unknown.

Methods: In 2006, a cross-sectional sample of 3876 Mexican adolescents in secondary school was surveyed on smoking behavior, smoking risk factors, and exposure to 42 popular films that contained smoking. Participants were classified into quartiles of exposure to smoking imagery across all films they reported having seen. Models were estimated to determine associations among quartiles of film-smoking exposure, smoking behavior, and the psychological antecedents of smoking, adjusting …

Association Between Muscular Strength And Mortality In Men: Prospective Cohort Study, Jonatan R. Ruiz, Xuemei Sui, Felipe Lobelo, James R. Morrow Jr., Allen W. Jackson, Michael Sjöström, Steven N. Blair

Faculty Publications

Objective: To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.

Design: Prospective cohort study.

Setting: Aerobics center longitudinal study.

Participants: 8762 men aged 20-80.

Main outcome measures: All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.

Results: During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age …

Heart Rate Variability Characteristics In Sedentary Postmenopausal Women Following Six Months Of Exercise Training: The Drew Study, Conrad P. Earnest, Carl J. Lavie, Steven N. Blair, Timothy S. Church

Faculty Publications

Background: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote improvement.

Methodology/Principle Findings: Our primary aim was to measure HRV in post-menopausal women following 6-moths of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% …

Maximal Exercise Electrocardiography Responses And Coronary Heart Disease Mortality Among Men With Diabetes Mellitus, G. William Lyerly, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Gregory A. Hand, Steven N. Blair

Faculty Publications

Background - An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus.

Methods and Results - We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to …

The Changing Role Of Physicians In Disaster Management And Hospital Incident Command, F. Matthew Mihelic, M. David Stockton, Stephen A. Cole, Gregory H. Blake

Faculty Publications

Recent changes in governmental policy toward disaster medicine and hospital incident command foreshadow a significant change in the role that physicians will play in disaster preparedness and response. The distinct discipline of Disaster Medicine has received authoritative recognition and promotion in the recent Homeland Security Presidential Directive 21, and recently established guidelines for incident command within hospitals have included a new position designated as “Medical/Technical Specialist(s)” that will assist the Incident Commander in disaster-related decision-making. This is a multidisciplinary position, and its functions can be filled by one or more individuals. As physician training and competency in Disaster Medicine increases, …

Race Differences In Activity, Fitness, And Bmi In Female Eighth Graders Categorized By Sports Participation Status, John R. Sirard, Karin A. Pfeiffer, Marsha Dowda, Russell R. Pate

Faculty Publications

The purpose of this study was to identify racial differences in physical activity (PA), fitness, and BMI in female 8th-grade sports participants and nonparticipants. Girls from 31 South Carolina middle schools (N=1,903, 48% White; mean age=13.6 ± 0.63) reported PA and previous year sports-team participation, completed a submaximal fitness test, and had height and weight measured. Sports team participation was positively associated with PA and negatively associated with television viewing and BMI, in a dose-response manner. Compared with Whites, African-Americans reported less PA and more television viewing, and had greater BMI scores. Whereas PA intervention programs that incorporate …

Physical Activity And Neighborhood Resources In High School Girls, Russell R. Pate, Natalie Colabianchi, Dwayne E. Porter, Maria João C. A. Almeida, Felipe Lobelo, Marsha Dowda

Faculty Publications

Background - Physical activity behavior is influenced by a person's physical environment, but few studies have used objective measures to study the influences of the physical environment on physical activity behavior in youth. The purpose of this study was to examine the relationship between selected neighborhood physical activity resources and physical activity levels in high school girls.

Methods - Participants were students in schools that had participated in a large physical activity intervention trial. The 3-Day Physical Activity Recall was completed by 1506 12th-grade girls. Data on physical activity facilities and resources in the participating communities were collected using a …

Promoting Physical Activity In Middle School Girls: Trial Of Activity For Adolescent Girls, Larry S. Webber, Diane J. Catellier, Leslie A. Lytle, David M. Murray, Charlotte A. Pratt, Deborah Rohm Young, John P. Elder, Timothy G. Lohman, June Stevens, Jared B. Jobe, Russell R. Pate

Faculty Publications

Background - Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls.

Design - Group randomized controlled trial.

Setting/participants - Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502).

Intervention - A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, …

Accumulating Disadvantage Over The Life Course: Evidence From A Longitudinal Study Investigating The Relationship Between Educational Advantage In Youth And Health In Middle Age, Katrina M. Walsemann, Arline T. Geronimus, Gilbert C. Gee

Faculty Publications

Recent studies suggest the importance of examining cumulative risk or advantage as potential predictors of health over the life course. Researchers investigating the cumulative health effects of education, however, have mainly conceptualized education in years or degrees, often disregarding educational quality and access to educational opportunities that may place individuals on divergent academic trajectories. We investigate whether educational advantages in youth are associated with an individual's health trajectory. We develop a novel index of educational advantage and employ random-intercept modeling using data from the National Longitudinal Survey of Youth. We find a widening health disparity in adulthood between respondents with …

Early Life Determinants Of Physical Activity In 11 To 12 Year Olds: Cohort Study, Calum Mattocks, Kevin Deere, Sam D. Leary, Andy R. Ness, Kate Tilling, Steven N. Blair, Chris J. Riddoch

Faculty Publications

Objective: To examine factors in early life (up to age 5 years) that are associated with objectively measured physical activity in 11-12 year olds.

Design: Prospective cohort study

Setting: Avon longitudinal study of parents and children, United Kingdom.

Participants: Children aged 11-12 years from the Avon longitudinal study of parents and children.

Main outcome measure: Physical activity levels in counts per minute (cpm) and minutes of moderate to vigorous physical activity for seven days measured with a uniaxial actigraph accelerometer.

Results: Valid actigraph data, defined as at least three days of physical activity for at least 10 hours a day, …

State Policies Matter: The Case Of Outpatient Drug Treatment Program Practices, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, D Eidson

Faculty Publications

This study examined relationships between state policy requirements governing outpatient substance abuse treatment services and reported outpatient treatment program practices. State policies effective as of February 1, 2003, and February 1, 2004, were collected and analyzed via primary legal research; data were validated by state officials (88% response rate; > 90% validation rate). Treatment practice data were obtained from the National Survey of Substance Abuse Treatment Services for the years 2003 and 2004. Multivariate analyses clustered by state were conducted, controlling for state, program, and state-aggregated client admission characteristics. Results indicated that treatment programs located in states with requirements for comprehensive …

Child Psychosocial Adjustment And Parenting In Families Affected By Maternal Hiv/Aids, Tanya L. Tompkins, Gail E. Wyatt

Faculty Publications

Child adjustment and parenting were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of …

Assessing The Professional Development Needs Of Public Health Educators In Light Of Changing Competencies, A. R. Demers, Edward M. Mamary

Faculty Publications

Introduction Because of the need for a well-trained public health workforce, professional competencies have been recently revised by the Institute of Medicine and the National Health Educator Competencies Update Project. This study compared the self-identified training needs of public health educators with the updated competencies and assessed employer support for continuing education. Methods A convenience sample of public health educators was recruited from an e-mail list of San Jose State University master of public health alumni. Respondents completed a Web-based survey that elicited information on emerging trends in public health education, training needs, and employer support for continuing education. Results …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …

Where's The Kale? Environmental Availability Of Fruits And Vegetables In Two Racially Dissimilar Communities, Edith M. Williams, Bamidele O. Tayo, Beverly Mclean, Ellen Smit, Christopher T. Sempos, Carlos J. Crespo

Faculty Publications

Minority communities across the United States have limited numbers of stores that offer a variety of fruits and vegetables, creating major barriers to good eating habits and nutritional practices among minority groups such as African Americans. Factors like environmental availability of healthy food options have not been fully investigated as possible sources of current cross-population differences in disease. The present study examined whether a predominantly African American neighborhood had disproportionately less availability of fruits and vegetables than a predominantly non-Hispanic White neighborhood. Availability was judged on the bases of the types of stores available in each community and the specific …

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

Individual Differences In The Conceptualization Of Food Across Eating Contexts, Christine E. Blake

Faculty Publications

Individual differences in food-related knowledge structures were explored by applying schema theory to examine the categories 42 adults used to classify foods across four eating contexts. Food card-sort labels were organized in 12 categories, category salience for each person was evaluated, and cluster analysis was used to identify clusters of participants according to the salience of their categories. Clusters were further evaluated for complexity and consistency of category use across contexts. Seven food schema clusters were identified. Meal/time and Routine categories were the most salient overall and were used by most clusters. Well-being, Person, Source, Convenience, Meal component, and Food …

The Effect Of Question Order On Reporting Physical Activity And Walking Behavior, Brent E. Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy, Steven P. Hooker

Faculty Publications

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: …

Polymorphisms In Methionine Synthase, Methionine Synthase Reductase And Serine Hydroxymethyltransferase, Folate And Alcohol Intake, And Colon Cancer Risk, Susan E. Steck, Temitope O. Keku, Lesley M. Butler, Joseph Galanko, Beri Massa, Robert C. Millikan, Robert S. Sandler

Faculty Publications

Background/Aims - We examined associations among folate and alcohol intake, SNPs in genes involved in one-carbon metabolism and colon cancer risk.

Methods - Colon cancer cases (294 African Americans and 349 whites) were frequency matched to population controls (437 African Americans and 611 whites) by age, race and sex from 33 North Carolina counties from 1996 to 2000. Folate and alcohol intakes were collected by dietary interview. Five SNPs were genotyped using DNA from whole blood: SHMT C1420T; MTRR A66G; MTR A2756G, and the previously-reported MTHFR C677T and MTHFR A1298C. Adjusted odds ratios (OR) and 95% …