Medicine and Health Sciences Commons^™

Higher Micronutrient Intake Is Associated With Human Papillomavirus-Positive Head And Neck Cancer: A Case-Only Analysis, Anna E. Arthur, Sonia A. Duffy, Gloria I. Sanchez, Stephen B. Gruber, Jeffrey E. Terrell, James R. Hébert, Emily Light, Carol R. Bradford, Nisha J. D'Silva, Thomas E. Carey, Gregory T. Wolf, Karen E. Peterson, Laura S. Rozek

Faculty Publications

No studies have investigated dietary differences between head and neck squamous cell carcinoma (HNSCC) patients with human papillomavirus (HPV)-positive tumors and patients with HPV-negative tumors. This study was designed to investigate the relationship between diet and HPV status in HNSCC patients. Cases of HNSCC were recruited from 2 clinical centers participating in the University of Michigan Head and Neck Specialized Program of Research Excellence (SPORE). HPV tissue genotyping was performed, and epidemiological and dietary data collected. Multivariable logistic regression tested whether pretreatment consumption of 12 selected micronutrients was significantly associated with HPV-positive status in 143 patients newly diagnosed with cancer …

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. …

Fitness And Adiposity As Predictors Of Functional Limitation In Adults, Andréa L. Maslow, Anna E. Price, Xuemei Sui, Duck-Chul Lee, Ilkka Vuori, Steven N. Blair

Faculty Publications

Background: This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.

Methods: Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age- and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.

Results: After adjusting for potential confounders and either BMI or WC, CRF …

Prostate Cancer Incidence Rates In Africa, Lisa W. Chu, Jamie Ritchey, Susan S. Devesa, Sabah M. Quraishi, Hongmei Zhang, Ann W. Hsing

Faculty Publications

African American men have among the highest prostate cancer incidence rates in the world yet rates among their African counterparts are unclear. In this paper, we compare reported rates among black men of Sub-Saharan African descent using data from the International Agency for Research on Cancer (IARC) and the National Cancer Institute Surveillance, Epidemiology, and End Results Program from 1973-2007. Although population-based data in Africa are quite limited, the available data from IARC showed that rates among blacks were highest in the East (10.7-38.1 per 100,000 man-years, age-adjusted world standard) and lowest in the West (4.7-19.8). These rates were considerably …

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

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 …

Association Between Depression And C-Reactive Protein, Yunsheng Ma, David E. Chiriboga, Sherry L. Pagoto, Milagros C. Rosal, Wenjun Li, Philip A. Merriam, James R. Hébert, Matthew C. Whited, Ira S. Ockene

Faculty Publications

Objective. Depression has been associated with increased cardiovascular disease risk, and a depression-related elevation of high sensitivity C-reactive protein (hs-CRP) has been proposed as a possible mechanism. The objective of this paper is to examine association between depression and high sensitivity C-reactive protein (hs-CRP). Methods. Subjects consisted of 508 healthy adults (mean age 48.5 years; 49% women, 88% white) residing in central Massachusetts. Data were collected at baseline and at quarterly intervals over a one-year period per individual. Multivariable linear mixed models were used to assess the association for the entire sample and by gender. Results. The …

Self-Rated Health Status And Cardiorespiratory Fitness As Predictors Of Mortality In Men, Jennifer Gander, Duck-Chul Lee, Xuemei Sui, James R. Hébert, Steven P. Hooker, Steven N. Blair

Faculty Publications

Self-rated health (SRH) and cardiorespiratory fitness (fitness) are independent risk factors for all-cause mortality. The purpose of this report is to examine the single and joint effects of these exposures on mortality risk. The study included 18 488 men who completed a health survey, clinical examination and a maximal exercise treadmill test during 1987–2003. Cox regression analysis was used to quantify the associations of SRH and fitness with all-cause mortality. There were 262 deaths during 17 years of follow-up. There was a significant inverse trend (p_trend <0.05) for mortality across SRH categories after adjustment for age, examination year, body mass index, physical activity, smoking, alcohol consumption, abnormal ECG, hypertension, hypercholesterolaemia, cardiovascular disease, diabetes and cancer. Adjustment for fitness attenuated the association (p value =0.09). The authors also observed an inverse association between fitness and mortality after controlling for the same covariates and SRH (p_trend = 0.006). The combined analysis of SRH and fitness showed that fit …

Rapides Parish Fins Cases Data Analysis For The Rapides Parish Court And Fins Program, Institute For Public Health And Justice, Data Collecting And Reporting

Policy & Position Papers

No abstract provided.

Physical Activity And Cognitive-Health Content In Top-Circulating Magazines, 2006–2008, Anna E. Greer, Sara J. Corwin, Daniela B. Friedman

All PTHMS Faculty Publications

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90–300 min of …

Fitness And Adiposity As Predictors Of Functional Limitation In Adults, Andréa L. Maslow, Anna E. Price, Xuemei Sui, Duck-Chul Lee, Ikka Vuori, Steven N. Blair

All PTHMS Faculty Publications

This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults. Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age-and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004. After adjusting for potential confounders and either BMI or WC, CRF was inversely related to …

Pcb-Contaminated Food In The Canadian Arctic: Interactions Between Environmental Policy, Cultural Values, And The Healthcare System, Katharine K. Brieger

Pomona Senior Theses

Current Canadian policies do not adequately prevent water contamination or mitigate the effects of existing polychlorinated biphenyl pollution. There is conflict between the Canadian government and the Inuit people over how to approach the pollution problem, arising from a clash of cultural values and traditions. Legislation related to healthcare is an inherently sensitive issue and some measures that seem acceptable to westernized societies are not appropriate for the Inuit. The purpose of this thesis is to answer (a) why polychlorinated biphenyls (PCBs) are in the Arctic, (b) what the effects of PCBs are on the Arctic people, and (c) how …

Radiological Population Monitoring: Views Of Public Health Professionals In The Southeastern United States, Gwendolyn N. Hudson

All ETDs from UAB

In the immediate aftermath of a radiological disaster, it is essential to rapidly screen the population to identify contaminated persons, those needing urgent medical treatment, and those requiring long-term follow-up. This process, known as "radiological population monitoring," is vital to reducing morbidity and mortality and effectively addressing people's health needs and concerns. Radiological population monitoring has become a significant new focus of attention and responsibility for government agencies in recent years, due in large part to growing concerns about the possibility of a terrorist attack involving radioactive materials. The primary responsibility for radiological population monitoring resides within state and local …

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

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 …

Fenofibrate And Insulin Resistance, Corrie E. Paeglow

All ETDs from UAB

Both animal and human models suggest that fenofibrate, a medication widely prescribed to decrease triglycerides, also decreases insulin resistance. In the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) cohort, which included 780 individual who took 160 mg of micronized fenofibrate daily for three weeks, fenofibrate was found to decrease HOMA-IR by -0.24 units, (95% CI: -0.32, -0.14), insulin by -0.65 uU/mL (95% CI: -0.97, -0.34) and glucose by 2.46 mg/dL (95% CI: -2.51, -2.42). In a meta-analysis of 19 studies that included 1,297 individuals without diabetes and 196 individuals with diabetes treated with fenofibrate for three weeks or …

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. …

Robust Nonparametric Regression Approach For Competing Cause Censored Survival Mortality Data With Covariates, Milind Arvind Phadnis

All ETDs from UAB

In the case of two or more competing risks when only the time to the event due to one risk is observable with times due to the other outcomes treated as censored observations, standard methods of survival analysis fall short of assessing the association of a set of predictors with the outcomes of interest. This problem is particularly severe when there is a differential association of a predictor with two competing risks (harmful for one risk and protective for the other risk) such as stroke and myocardial infarction and in situations where the predictor is associated with only one risk …

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 …

Individual, Socio-Cultural And Structural Factors Associated With Cervical Cancer Screening And Treatment In Tanzania, Renicha Tomeka Mccree-Hale

All ETDs from UAB

Most African countries including Tanzania have limited cervical cancer screening and treatment programs. Only about 5% of women have ever been screened for cervical cancer. A constellation of individual and structural factors contributes to the challenge of cervical cancer screening and treatment in countries that bear significant burdens of disease. Yet, little is known about country specific factors that may constrain or facilitate scale up of health services. This dissertation is an attempt to identify and understand the country specific individual and structural barriers along with facilitators to cervical cancer screening and treatment in Tanzania. Individual, institutional and structural level …

Adsorption Characteristics Of Activated Carbon Fibers (Acfs) For Toluene, Jo Anne Goot Balanay

All ETDs from UAB

Granular activated carbon (GAC) is currently the standard adsorbent in respirators against several gases and vapors because of its efficiency, low cost and available technology. However, a drawback of GAC due to its granular form is its need for containment, adding weight and bulkiness to respirators. This makes respirators uncomfortable to wear, resulting to poor compliance in its use. Activated carbon fiber (ACF) is considered a viable alternative adsorbent material for developing thinner, light-weight and efficient respirators because of their larger surface area, lighter weight and fabric form. This study aims to determine the critical bed depth and adsorption capacity …

An Examination Of Statistical Methods For Longitudinal Mediation Modeling, John Paul Bentley

All ETDs from UAB

The use of mediation modeling is quite prevalent in a number of disciplines to answer questions about how or why one variable exerts its influence on another variable. Although mediation can be assessed in the context of several types of study designs, the use of cross-sectional data and a single-mediator model tend to be the most commonly reported features in empirical tests of mediation. There are several limitations associated with assessing mediation with cross-sectional data, perhaps the most significant is that mediated effect estimates are biased in the case of true longitudinal mediation. For this and several other reasons, there …

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

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

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 …

Occupational Stress In Veterinary Support Staff, Sandra Morales Foster

All ETDs from UAB

OCCUPATIONAL STRESS IN VETERINARY SUPPORT STAFF Sandra Morales Foster DOCTOR OF PUBLIC HEALTH ABSTRACT Limited information exists about veterinary support staff and the occupational stressors of this workforce. Concern for workers in occupations of high or prolonged stress such as caregivers in hospitals and emergency situations has been noted in many studies. Occupational stress can cause harmful physical and emotional outcomes when the homeostatic balance is upset. This study explored occupational stress, health status, and coping strategies of veterinary support staff. A mixed-method collected quantitative and qualitative data. Demographic information and three validated instruments were ad-ministered using a web-based survey; …

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 …

Conceptualization Of Cervical Cancer And Screening Experiences Among Zambian Women Attending A Cervical Screening Program, Heather Leah White

All ETDs from UAB

Invasive cervical cancer (ICC) is the second most commonly diagnosed malignancy worldwide, and approximately 85% of the disease burden occurs in underdeveloped countries. In 2006, the Zambian government launched a cervical screening program within primary health clinics using visual inspection with acetic acid (VIA) coupled with immediate treatment via cryotherapy. The objective of this dissertation was to determine whether the VIA screening program is responsive to the needs and concerns of Zambian women in an effort to improve screening uptake, and for human immunodeficiency virus (HIV) positive women who are potentially subject to increased ICC screening and treatment, increase long-term …

Pick It Up, Put It Down: A Grounded Theory Study Of How Low Income African American Patients In The Deep South Start Smoking And Quit Smoking, Jessica Hillman Williams

All ETDs from UAB

The purpose of this qualitative was to use data extracted from the narrative stories of African American patients to generate a grounded theory to explain the process and act of initiating and of quitting smoking among low income African American patients in the Deep South. This is important since African Americans are more likely to suffer from smoking-related illnesses, which are the leading cause of death among African Americans. Data were analyzed from interviews conducted in 2005 as part of the Stories Project and supplementary interviews conducted in 2011. Convenience sampling strategies guided participant recruitment for primary interviews and theoretical …

Encontrando La Comida Saludable: Identifying Food Access Barriers For The Adams County, Pennsylvania Latino Community, Gwendolyn D. Brown, Olivia A. Haddad

Student Publications

Overwhelming research indicates that recent national trends in U.S. food systems have led to the increased prevalence of processed foods and associated diet-related diseases. The effects of unhealthy diets have been distributed unevenly across the country’s socioeconomic and ethnic groups. Certain socioeconomic and ethnic groups face greater geographic, financial and cultural barriers to healthy food access. In Adams County, Pennsylvania, Latinos comprise 5.6% of the population, making them the county’s largest minority group, yet little is known about the food access barriers they face. In this study, we used a combination of surveys and focus groups with Latino residents and …