Medicine and Health Sciences Commons^™

School Food Environment The Frontline For Childhood Obesity Prevention: A Mixed-Method Study Of Nutritional Competencies And Skills Of School Nutriiton Professionals In Nebraska, Zainab Rida

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

The purpose of this statewide study was to address the nutrition knowledge, attitudes, and perceptions of school foodservice personnel in Nebraska regarding offering/serving healthy school meals. Moreover, this study identified some potential barriers and avenues of action for offering/serving healthy school meals. Data obtained from this study indicates that there is a strong correlation (r= .103, p r .237, p< .01) between the foodservice staff’s self-efficacy and their practices of offering/serving healthy school meals. Fortunately, the relationship between foodservice staff practices of offering/serving healthy school meals and their self-efficacy was positive and significantly predicted practices scores, β =.237, P< 0.01. The finding of the present study also identifies many barriers including lack of time and support that face the foodservice personnel in offering/serving healthy school meals. The findings suggested that there is an urgent need of a full school approach to promote and encourage healthy eating habits among students. Future research is needed to evaluate school wellness policies regarding healthy eating practices in schools. Moreover, establish partnerships with communities and universities for intervention that target students and their parents.

Advisor: Wanda Koszewski

A Mixed Methods Approach To Food Safety Knowledge, Beliefs And Practices In Hispanic Families With Young Children In Nebraska, Kristen M. Stenger

College of Education and Human Sciences: Dissertations, Theses, and Student Research

This mixed methods study addresses food safety for Hispanic families with young children in Nebraska. A convergent mixed methods design was used, where qualitative and quantitative data were collected in parallel, analyzed separately and then merged in analysis and interpretation. A quantitative food safety knowledge survey (n=90, 52 from focus groups, 38 from piloting the survey), was used to assess the FightBac!™ concepts: Clean, Separate, Cook, Chill, and two additional concepts: foods that increase risk, and groups at increased risk. Qualitative focus groups explored food safety handling beliefs and practices through the lens of the Health Belief Model. Focus groups …

All-Cause Gastroenteritis And Rotavirus-Coded Hospitalizations Among Us Children, 2000–2009, Rishi Desai, Aaron T. Curns, Claudia A. Steiner, Jacqueline E. Tate, Manish M. Patel, Umesh D. Parashar

Public Health Resources

Background. Rotavirus vaccine was recommended for US infants in 2006. We estimated baseline prevaccine burden and monitored postvaccine trends in gastroenteritis-coded and rotavirus-coded hospitalizations among US children.

Methods. We analyzed data from the State Inpatient Databases (SID) for 29–44 US states over a 10-year period (2000–2009) to calculate gastroenteritis and rotavirus-coded hospitalization rates by age group, sex, and region, among children <5 years of age. By extrapolating observed pre- and postvaccine gastroenteritis hospitalization rates to the US population <5 years and based on the 2009 cost of a diarrhea hospitalization, we estimated national reductions in diarrhea hospitalizations and associated treatment costs.

Results. The prevaccine (2000–2006) annual average gastroenteritis-coded hospitalization rate among children <5 years of age was 74 per 10 000 (annual range, 71–82 per 10 000), and declined to 51 and 50 per 10 000 in 2008 and 2009, respectively (P < .001). The prevaccine (2000–2006) annual average rotavirus-coded hospitalization rate among children <5 years of age was 15 per 10 000 (annual range, 13–18 per 10 000), and declined to 5 and 6 per 10 000 in 2008 and 2009, respectively (P < .001). The decreases in rotavirus-coded hospitalization rates in 2008 and 2009 compared with rates in prevaccine years were observed among all age groups and US regions. Nationally, during 2008 and 2009 combined, we estimated a reduction of approximately 77 000 diarrhea hospitalizations and approximately $242 million in hospital costs.

Conclusions. Since implementation of the US rota-virus vaccination program, a marked reduction in diarrhea hospitalizations and related hospital charges has occurred among US children.

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …

Evaluation Of Pneumonia Virus Of Mice As A Possible Human Pathogen, Linda G. Brock, Ruth A. Karron, Christine D. Krempl, Peter L. Collins, Ursula J. Buchholz

Public Health Resources

Pneumonia virus of mice (PVM), a relative of human respiratory syncytial virus (RSV), causes respiratory disease in mice. There is serologic evidence suggesting widespread exposure of humans to PVM. To investigate replication in primates, African green monkeys (AGM) and rhesus macaques (n=4) were inoculated with PVM by the respiratory route. Virus was shed intermittently at low levels by a subset of animals, suggesting poor permissiveness. PVM efficiently replicated in cultured human cells and inhibited the type I interferon (IFN) response in these cells. This suggests that poor replication in nonhuman primates was not due to a general nonpermissiveness …

Genome-Wide Mirnaprofiling Of Mantle Cell Lymphoma Reveals A Distinct Subgroup With Poor Prognosis, Javeed Iqbal, Yulei Shen, Yanyan Liu, Kai Fu, Elaine S. Jaffe, Cuiling Liu, Zhongfeng Liu, Cynthia M. Lachel, Karen Deffenbacher, Timothy C. Greiner, Julie M. Vose, Sharathkumar Bhagavathi, Louis M. Staudt, Lisa Rimsza, Andreas Rosenwald, German Ott, Jan Delabie, Elias Campo, Rita M. Braziel, James R. Cook, Raymond R. Tubbs, Randy D. Gascoyne, James O. Armitage, Dennis D. Weisenburger, Timothy W. Mckeithan, Wing C. Chan

Public Health Resources

miRNA deregulation has been implicated in the pathogenesis of mantle cell lymphoma (MCL). Using a high-throughput quantitative real-time PCR platform, we performed miRNA profiling on cyclin D1–positive MCL (n = 30) and cyclin D1–negative MCL (n =7) and compared them with small lymphocytic leukemia/ lymphoma (n =12), aggressive B-cell lymphomas (n =138), normal B-cell subsets, and stromal cells.We identified a 19-miRNA classifier that included 6 up-regulated miRNAs and 13 down regulated miRNA that was able to distinguish MCL from other aggressive lymphomas. Some of the up-regulated miRNAs are highly expressed in naive B cells. This miRNAclassifier …

Effectiveness Of Supported Employment For Veterans With Spinal Cord Injuries: Results From A Randomized Multisite Study, Lisa Ottomanelli, Lance L. Goetz, Alina Suris, Charles Mcgeough, Patricia L. Sinnott, Rich Toscano, Scott D. Barnett, Daisha J. Cipher, Lisa M. Lind, Thomas M. Dixon, Sally Ann Holmes, Anthony J. Kerrigan, Florian P. Thomas

Public Health Resources

Ottomanelli L, Goetz LL, Suris A, McGeough C, Sinnott PL, Toscano R, Barnett SD, Cipher DJ, Lind LM, Dixon TM, Holmes SA, Kerrigan AJ, Thomas FP. Effectiveness of supported employment for veterans with spinal cord injuries: results from a randomized multisite study.

Objective: To examine whether supported employment (SE) is more effective than treatment as usual (TAU) in returning veterans to competitive employment after spinal cord injury (SCI).

Design: Prospective, randomized, controlled, multisite trial of SE versus TAU for vocational issues with 12 months of follow-up data.

Setting: SCI centers in the Veterans Health Administration.

Participants: …

Molecular Distinctions Between Pediatric And Adult Mature B-Cell Non-Hodgkin Lymphomas Identified Through Genomic Profiling, Karen Deffenbacher, Javeed Iqbal, Warren Sanger, Yulei Shen, Cynthia Lachel, Zhongfeng Liu, Yanyan Liu, Megan Lim, Sherrie Perkins, Kai Fu, Lynette Smith, James Lynch, Louis Staudt, Lisa M. Rimsza, Elaine Jaffe, Andreas Rosenwald, German Ott, Jan Delabie, Elias Campo, Randy Gascoyne, Mitchell Cairo, Dennis Weisenburger, Timothy Greiner, Thomas Gross, Wing Chan

Public Health Resources

Burkitt lymphoma (BL) predominates in pediatric patients, whereas diffuse large B-cell lymphoma (DLBCL) is uncommon. In contrast to adults, BL and DLBCL are treated similarly in children and both entities have superior outcomes in children compared with adults. Gene expression profiling (GEP) and miRNA expression profiling clearly differentiated pediatric DLBCL from BL, forming distinct clusters regardless of patient age. However, pathway analysis of GEP data identified minor differences between corresponding pediatric and adult tumors. Predominance (6:1) of the germinal center B-cell subtype to activated B-cell subtype was found among pediatric DLBCL. Two cases were molecularly classified as primary mediastinal B-cell …

Genome-Wide Microrna Profiling Of Mantle Cell Lymphoma Reveal A Distinct Subgroup With Poor Prognosis, Javeed Iqbal, Yulei Shen, Yanyan Liu, Kai Fu, Elaine Jaffe, Cuiling Liu, Zhongfeng Liu, Cynthia Lachel, Karen Deffenbacher, Timothy Greiner, Julie Vose, Sharathkumar Bhagavathi, Louis Staudt, Lisa Rimsza, Andreas Rosenwald, German Ott, Jan Delabie, Elias Campo, Rita Braziel, James Cook, Raymond Tubbs, Randy Gascoyne, James Armitage, Dennis Weisenburger, Timothy Mckeithan, Wing Chan

Public Health Resources

MicroRNA (miRNA) deregulation has been implicated in the pathogenesis of mantle cell lymphoma (MCL). Using a high-throughput quantitative real-time PCR platform, we performed miRNA profiling on cyclin D1- positive MCL (n=30) and cyclin D1-negative MCL (n=7) and compared them with small lymphocytic leukemia/lymphoma (SLL, n=12), aggressive B-cell lymphomas (n=138), normal B-cell subsets and stromal cells. We identified a 19-miRNA classifier which included six upregulated miRNAs (miR-135a, miR-708, miR-150, miR-363, miR-184, miR-342-5p) and 13 downregulated miRNAs, that was able to distinguish MCL from other aggressive lymphomas with >90% probability. Some of these upregulated miRNAs are highly expressed in naïve B-cells. MicroRNA …

Effects Of Leptin Replacement Alone And With Exendin-4 On Food Intake And Weight Regain In Weight-Reduced Diet-Induced Obese Rats, Roger Reidelberger, Alvin Haver, Prasanth K. Chelikani, Bettye Apenteng, Curtis Perriotte-Olson, Krista Anders, Sharalyn Steenson, James E. Blevins

Public Health Resources

Reidelberger R, Haver A, Chelikani PK, Apenteng B, Perriotte-Olson C, Anders K, Steenson S, Blevins JE. Effects of leptin replacement alone and with exendin-4 on food intake and weight regain in weight-reduced diet-induced obese rats. Am J Physiol Endocrinol Metab 302: E1576–E1585, 2012. First published April 17, 2012; doi:10.1152/ajpendo.00058.2012.—Weight loss in obese humans produces a relative leptin deficiency, which is postulated to activate potent orexigenic and energy conservation mechanisms to restrict weight loss and promote weight regain. Here we determined whether leptin replacement alone or with GLP-1 receptor agonist exendin-4 attenuates weight regain or promotes greater weight loss in weight-reduced …

Benchmarking Us Department Of Veterans Affairs Dermatologic Services: Results From A National Survey, L. Kendall Krause, Leilani Townsend, Michael L. Orser, Jennifer Mulhausen, Jodi Duke, Weston T. Waxweiler, Robert P. Dellavalle

Public Health Resources

Background: How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature.

Objective: We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA.

Methods: Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed.

Results: Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained …

Human Risk Of Infection With Borrelia Burgdorferi, The Lyme Disease Agent, In Eastern United States, Maria A. Diuk-Wasser, Anne Gatewood Hoen, Paul Cislo, Robert Brinkerhoff, Sarah A. Hamer, Michelle Rowland, Roberto Cortinas, Gwenaël Vourc’H, Forrest S. Melton, Graham J. Hickling, Jean I. Tsao, Jonas Bunikis, Alan G. Barbour, Uriel Kitron, Joseph Piesman, Durland Fish

Department of Entomology: Faculty Publications

The geographic pattern of human risk for infection with Borrelia burgdorferi sensu stricto, the tick-borne pathogen that causes Lyme disease, was mapped for the eastern United States. The map is based on standardized field sampling in 304 sites of the density of Ixodes scapularis host-seeking nymphs infected with B. burgdorferi, which is closely associated with human infection risk. Risk factors for the presence and density of infected nymphs were used to model a continuous 8 km × 8 km resolution predictive surface of human risk, including confidence intervals for each pixel. Discontinuous Lyme disease risk foci were identified in …

Characterization Of Pasteurella Multocida Strains Isolated From Geese, Zsuzsanna Varga, Dmitriy V. Volokhov, Laszlo Stipkovits, Akos Thuma, Boglarka Sellyei, Tibor Magyar

Food and Drug Administration Papers

Phenotypic and genotypic diversity of forty-two Pasteurella multocida isolates from geese were characterized by analysis of their capsular type, Heddleston serotype, biotype, fimbrial gene allele type, comparative outer membrane protein (OMP) electrophoresis patterns, and were analyzed using PCR for the presence of virulence-associated genes (toxA, tbpA, pfhA, hgbA, hgbB, nanH, nanB, fimA, hsf-1, and pmHAS). A sequence comparison of the thdF and rpoB housekeeping genes of twenty representative P. multocida strains from three different OMP groups demonstrated that seventeen strains were closely related phylogenetically to previously published strains of P. multocida subsp. multocida and P. multocida subsp. gallicida, and only …

The Association Between Depression And Anxiety And Use Of Oral Health Services And Tooth Loss, Catherine A. Okoro, Tara W. Strine, Paul I. Eke, Satvinder S. Dhingra, Lina S. Balluz

Public Health Resources

Objective: The purpose of this study is to examine the associations among depression, anxiety, use of oral health services, and tooth loss.

Methods: Data were analysed for 80 486 noninstitutionalized adults in 16 states who participated in the 2008 Behavioral Risk Factor Surveillance System. Binomial and multinomial logistic regression analyses were used to estimate predicted marginals, adjusted prevalence ratios, adjusted odds ratios (AOR) and their 95% confidence intervals (CI).

Results: The unadjusted prevalence for use of oral health services in the past year was 73.1% [standard error (SE), 0.3%]. The unadjusted prevalence by level of tooth loss …

Improving Outpatient Diabetes Care, Susan Kirsh, Michael Hein, Leonard Pogach, Gordon Schectman, Lauren Stevenson, Sharon Watts, Archana Radhakrishnan, John Chardos, David Aron

Public Health Resources

More than 20% of patients in the Veterans Health Administration (VHA) have diabetes; therefore, disseminating “best practices” in outpatient diabetes care is paramount. The authors’ goal was to identify such practices and the factors associated with their development. First, a national VHA diabetes registry with 2008 data identified clinical performance based on the percentage of patients with an A1c >9%. Facilities (n = 140) and community-based outpatient clinics (n = 582) were included and stratified into high, mid, and low performers. Semistructured telephone interviews (31) and site visits (5) were conducted. Low performers cited lack of teamwork between physicians and …

Association Between Acculturation And Breastfeeding Among Hispanic Women: Data From The Pregnancy Risk Assessment And Monitoring System, Indu B. Ahluwalia, Denise D’Angelo, Brian Morrow, Jill A. Mcdonald

Public Health Resources

Background: Breastfeeding rates are typically higher among Hispanic women; however, they vary by acculturation status in that those more acculturated are less likely to breastfeed than those who are less acculturated. This study examined the association between acculturation and breastfeeding behaviors using population-based data.

Methods: Data (N = 8942) from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used for analysis. Acculturation status was determined using self-reported Hispanic ethnicity and the language in which the women responded to the PRAMS survey, either English or Spanish. Hispanic women who responded to the survey in Spanish were categorized as less acculturated than …

Most Physicians Were Eligible For Federal Incentives In 2011, But Few Had Ehr Systems That Met Meaningful-Use Criteria, Chun-Ju Hsiao, Sandra Decker, Esther Hing, Jane Sisk

Public Health Resources

As more physicians adopt electronic health record systems in their practices, policy interest is focusing on whether physicians are ready to meet the federal “meaningful use” criteria—a vital threshold to qualify for financial incentives. In our analysis of a 2011 nationally representative survey of office-based physicians, we found that 91 percent of physicians were eligible for Medicare or Medicaid meaningful-use incentives. About half of all physicians intended to apply. However, only 11 percent both intended to apply for the incentives and had electronic health record systems with the capabilities to support even two-thirds of the stage 1 core objectives required …

United States Registered Nurse Workforce Report Card And Shortage Forecast, Stephen P. Juraschek, Xiaoming Zhang, Vinoth K. Ranganathan, Vernon Lin

Public Health Resources

Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand

is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed

demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned

based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN

shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - …

Clinical Research And Development Of Tuberculosis Diagnostics: Moving From Silos To Synergy, Payam Nahid, Peter S. Kim, Carlton A. Evans, David Alland, Michael Barer, Jane Diefenbach, Jerrold Ellner, Richard Hafner, Carol Dukes Hamilton, Michael F. Iademarco, Gregory Ireton, Michael E. Kimerling, Christian Lienhardt, William R. Mackenzie, Megan Murray, Mark D. Perkins, Jamie E. Posey, Teri Roberts, Christine Sizemore, Wendy S. Stevens, Laura Via, Sharon D. Williams, Wing Yew, Susan Swindells

Public Health Resources

The development, evaluation, and implementation of new and improved diagnostics have been identified as critical needs by human immunodeficiency virus (HIV) and tuberculosis researchers and clinicians alike. These needs exist in international and domestic settings and in adult and pediatric populations. Experts in tuberculosis and HIV care, researchers, healthcare providers, public health experts, and industry representatives, as well as representatives of pertinent US federal agencies (Centers for Disease Control and Prevention, Food and Drug Administration, National Institutes of Health, United States Agency for International Development) assembled at a workshop proposed by the Diagnostics Working Group of the Federal Tuberculosis Taskforce …

Replicating Adenovirus-Simian Immunodeficiency Virus (Siv) Vectors Efficiently Prime Siv-Specific Systemic And Mucosal Immune Responses By Targeting Myeloid Dendritic Cells And Persisting In Rectal Macrophages, Regardless Of Immunization Route, L. Jean Patterson, Seraphin Kuate, Mara Daltabuit-Test, Qingsheng Li, Peng Xiao, Katherine Mckinnon, Janet Dipasquale, Anthony Cristillo, David Venzon, Ashley Haase, Marjorie Robert-Guroff

Public Health Resources

Although priming with replicating adenovirus type 5 host range mutant (Ad5hr)-human immunodeficiency virus (HIV)/simian immunodeficiency virus (SIV) recombinants, followed by HIV/SIV envelope boosting, has proven highly immunogenic, resulting in protection from SIV/simian-human immunodeficiency virus (SHIV) challenges, Ad5hr recombinant distribution, replication, and persistence have not been examined comprehensively in nonhuman primates. We utilized Ad5hr-green fluorescent protein and Ad5hr-SIV recombinants to track biodistribution and immunogenicity following mucosal priming of rhesus macaques by the intranasal/intratracheal, sublingual, vaginal, or rectal route. Ad recombinants administered by all routes initially targeted macrophages in bronchoalveolar lavage (BAL) fluid and rectal tissue, later extending to myeloid dendritic cells …

The Use Of Low-Calorie Sweeteners By Children: Implications For Weight Management, John Foreyt, Ronald Kleinman, Rebecca Brown, Rachel Lindstrom

Public Health Resources

The rise in pediatric obesity since the 1970s has been well established in the United States and is becoming a major concern worldwide. As a potential means to help slow the obesity epidemic, low-calorie sweeteners (LCS) have gained attention as dietary tools to assist in adherence to weight loss plans or prevention of excess weight gain. Observational studies tend to show positive correlations between LCS consumption and weight gain in children and adolescents. Although the data are intriguing, these epidemiologic studies do not establish that LCS cause weight gain, because there are likely many lifestyle and genetic differences between children …

Salmonella Enterica Serotype Enteritidis: Increasing Incidence Of Domestically Acquired Infections, Shua J. Chai, Patricia L. White, Sarah L. Lathrop, Suzanne M. Solghan, Carlota Medus, Beth Mcglinchey, Melissa Tobin-D'Angelo, Ruthanne Marcus, Barbara Mahon

Public Health Resources

Background. Salmonella enterica causes an estimated 1 million cases of domestically acquired foodborne illness in humans annually in the United States; Enteritidis (SE) is the most common serotype. Public health authorities, regulatory agencies, food producers, and food processors need accurate information about rates and changes in SE infection to implement and evaluate evidence-based control policies and practices.

Methods. We analyzed the incidence of human SE infection during 1996–2009 in the Foodborne Diseases Active Surveillance Network (FoodNet), an active, population-based surveillance system for laboratory-confirmed infections. We compared FoodNet incidence with passively collected data from complementary surveillance systems and with …

The Structure Of Posttraumatic Psychopathology In Veterans Attending Primary Care, David Forbes, Jon D. Elhai, Emma Lockwood, Mark Creamer, B. Christopher Frueh, Kathryn M. Magruder

Public Health Resources

This study attempted to extend research indicating that posttraumatic stress disorder (PTSD) factors of Re-experiencing, Avoidance and Hyperarousal are more related to Fear/phobic disorders, while PTSD Dysphoria is more related to Anxious-Misery disorders. Trauma exposure, PTSD and comorbidity data for 668 veteran patients were analysed using confirmatory factor analyses and relative strengths of the relationships between PTSD factors and the Fear and Anxious-Misery factors were assessed. Combining Simms, Watson, and Doebbeling’s (2002) model of PTSD symptoms and Krueger’s (1999) Fear/Anxious Misery model of mood and anxiety disorders fit the data well. Contrary to previous research, PTSD Reexperiencing, Avoidance and Hyperarousal …

Trends In Total Laryngectomy In The Era Of Organ Preservation: A Population- Based Study, Patrick Tate Maddox, Louise Davies

Public Health Resources

Objective. To describe time trends in total laryngectomy health services utilization across the United States, such as rates of surgery, cost, length of stay, and insurance payer, and to compare this to important milestones in recommendations for laryngeal cancer treatment.

Study Design. Population-based cohort study

Setting. Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) 1997-2008: stratified sample of all US hospital discharges.

Subjects and Methods. All patients with the principal procedure of complete laryngectomy. The unit of analysis was the discharge.

Results. Between 1997 and 2008, the number of laryngectomies done in the United States …

Women At War: Understanding How Women Veterans Cope With Combat And Military Sexual Trauma, Kristin M. Mattocks, Sally G. Haskell, Erin E. Krebs, Amy C. Justice, Elizabeth M. Yano, Cynthia Brandt

Public Health Resources

The wars in Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF) have engendered a growing population of US female veterans, with women now comprising 15% of active US duty military personnel. Women serving in the military come under direct fire and experience combatrelated injuries and trauma, and are also often subject to in-service sexual assaults and sexual harassment. However, little is known regarding howwomen veterans cope with these combat and military sexual trauma experiences once they return from deployment. To better understand their experiences, we conducted semi-structured interviews with nineteen OEF/OIF women veterans between JanuaryeNovember 2009. Women …

Factors Associated With Screening Or Treatment Initiation Among Male United States Veterans At Risk For Osteoporosis Fracture, Richard E. Nelson, Jonathan R. Nebeker, Brian C. Sauer, Joanne Lafleur

Public Health Resources

Male osteoporosis continues to be under-recognized and undertreated in men. An understanding of which factors cue clinicians about osteoporosis risk in men, and which do not, is needed to identify areas for improvement. This study sought to measure the association of a provider's recognition of osteoporosis with patient information constructs that are available at the time of each encounter. Using clinical and administrative data from the Veterans Health Administration system, we used a stepwise procedure to construct prognostic models for a combined outcome of osteoporosis diagnosis, treatment, or a bone mineral density (BMD) test order using time-varying covariates and Cox …

Β2 Adrenergic Receptor Agonists And Steroids Inhibit Cafo Dust-Mediated Bronchial Epithelial Inflammation In Vitro, D. J. Romberger, K. Palm, A. J. Heires, T. M. Nordgren, M. L. Toews, T. A. Wyatt

Public Health Resources

Rationale: Agricultural workers employed in concentrated animal feeding operations (CAFOs) are repeatedly exposed to aerosolized dust, and are susceptible to inflammatory lung diseases including COPD. Aqueous extracts of agricultural dust collected from swine CAFOs (HDE) have been shown to be potent inflammatory stimulators in human cells and in vivo mouse models. HDE exposure augments proinflammatory cytokine release, ICAM-1 expression, PKC activation, and lymphocyte and neutrophil adhesion to airway epithelial cells. Because ₂ adrenergic receptor agonists (β-agonists) alone, and in combination with corticosteroids, have been used to treat COPD, we examined the ability of these agents to diminish the inflammatory …

Cytokine Responses In Whole Blood Assay In Veterans With Agriculture Work Exposures, J. D. J. Romberger, J. L. Meza, E.C. Chickris, A. J. Heires, R. M. Zotti-Pierce, T. D. Levan

Public Health Resources

RATIONALE: Agriculture exposures are associated with increased risk of chronic obstructive pulmonary disease (COPD). Endotoxin exposure in agricultural environments is associated with lung disease. Our objective was to evaluate responsiveness to endotoxin stimulation in an in vitro whole blood assay and its association with COPD in an agriculturally exposed cohort.

METHODS: Veterans with ≥ two years agricultural work exposure participated in this case-control study. Cases are veterans with COPD defined as FEV1/FVC ratio < 70% on spirometry post-bronchodilator. Controls did not have COPD as assessed by spirometry nor other significant lung conditions. Whole blood assay (WBA) was done with 2 ml heparinized blood mixed with 2 ml of media and stimulated with increasing doses of LPS (0 – 1 ng/ml). Samples were incubated at 37°C for 24 hours, centrifuged, supernatants harvested and frozen until assayed for cytokines by ELISA. Cytokine values were log transformed. Repeated measures ANOVA was used to examine the association between LPS dose and group (case or control) and the interaction of dose with group. All p values were adjusted for age.

RESULTS: There were 272 participants, 110 cases with COPD and 158 controls. Baseline demographics (gender, age, race) were similar between cases and controls. LPS-stimulated …

Scavenger Receptor A Activation Enhances Peptidoglycan-Stimulated Interleukin-8 Release In Bronchial Epithelium, J. P. Berger, K. L. Bailey, J. M. Devasure, D. J. Romberger, T. A. Wyatt

Public Health Resources

INTRODUCTION: The immune response to certain pathogens or cellular stressors is initiated and regulated by pattern recognition receptors of the innate immune system. Pattern recognition receptors are effective by utilizing either endocytic (Scavenger Receptors) or signaling receptors (Toll-like Receptors). It has been previously demonstrated that mouse dendritic cells deficient in scavenger receptor A (SRA) negatively regulated the immune response produced by Toll-like receptors when exposed to modified lipid proteins. Previously, we have shown that peptidoglycan contained in organic dust from swine barns stimulates pro-inflammatory cytokine release in bronchial epithelium. We hypothesized bronchial epithelial SRA would also have a regulatory …

Fish Oil And Indomethacin In Combination Potently Reduce Dyslipidemia And Hepatic Steatosis In Ldlr-/- Mice, Ganesan Murali, Ginger L. Milne, Corey Webb, Ann B. Stewart, Ryan P. Mcmillan, Brandon C. Lyle, Matthew W. Hulver, Viswanathan Saraswathi

Public Health Resources

Fish oil (FO) is a potent anti-inflammatory and lipid-lowering agent. Because inflammation can modulate lipid metabolism and vice versa, we hypothesized that combining FO with cyclooxygenase inhibitors (COXIBs), well-known anti-inflammatory drugs, can enhance the anti-inflammatory and lipid-lowering effect of FO. LDLR-/- mice were fed a high fat diet supplemented with 6% olive oil or FO for 12 wk in the presence or absence of indomethacin (Indo, 6mg/liter drinking water). FO reduced plasma total cholesterol by 30% but in combination with Indo, exerted a greater decrease (44%). The reduction of liver cholesterol ester (CE) and triglycerides (TG) by FO (63% …