Public Health Commons^™

Perimenopausal Obesity, Colleen Keller, Linda Larkey, Johanna K. Distefano, Edna Boehm-Smith, Kathie Records, Alyssa G. Robillard, Sharry Veres, Manal Al-Zadjali, Anne-Marie O'Brian

Faculty Publications

Obesity is recognized as one of the most important underlying risk factors for a wide variety of diseases, including heart disease and diabetes. Women are particularly prone to obesity, and approaches that address life transitions across the life span suggest that a number of factors may converge at passage points, such as menopause, that contribute to weight accumulation in the aging woman. The menopausal phase of a woman's life brings a number of changes that may trigger and maintain weight gain. Although the prevalence of overweight and obesity is attributable to each of these factors, it is most likely the …

Parental Report Versus Child Perception Of Familial Support: Which Is More Associated With Child Physical Activity And Television Use?, Daheia J. Barr-Anderson, Ramona Robinson-O'Brien, Jess Haines, Peter J. Hannan, Dianne R. Neumark-Sztainer

Faculty Publications

Background: Parent-report and child perception of familial support for weight-related behaviors may not be congruent. This research explores whether parent-report or child perception is more strongly associated with child-reported physical activity and television (TV) use. Methods: Elementary school children (n = 73) participating in Ready. Set. ACTION!, a theater-based obesity prevention pilot program in Saint Paul, MN, and their parents completed surveys assessing familial support for physical activity and limitations on TV use in fall 2006. Paired t tests examined congruency between parent-report and child perception. Linear regression models adjusted for sociodemographics explored the associations between familial …

Latin America And The Caribbean: Assessment Of The Advances In Public Health For The Achievement Of The Millennium Development Goals, Amal K. Mitra, Gisela Rodriguez-Fernandez

Faculty Publications

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN …

The Influence Of Cardiorespiratory Fitness On Lung Cancer Mortality, Xuemei Sui, Duck-Chul Lee, Charles E. Matthews, Swann Arp Adams, James R. Hébert, Timothy S. Church, Chong-Do Lee, Steven N. Blair

Faculty Publications

Purpose—Previous studies have suggested that higher levels of physical activity may lower lung cancer risk; however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. Methods—Thirty-eight thousand men, aged 20 to 84 years without history of cancer, received a preventive medical examination at the Cooper Clinic in Dallas, TX, between 1974 and 2002. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). Results—A total of 232 lung cancer …

Food Insecurity As A Barrier To Sustained Antiretroviral Therapy Adherence In Uganda, Sheri D. Weiser, David M. Tuller, Edward A. Frongillo Jr., Jude Senkungu, Nozmu Mukiibi, David R. Bangsberg

Faculty Publications

Background: Food insecurity is emerging as an important barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, but little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions.

Methodology: We conducted in-depth, open-ended interviews with 47 individuals (30 women, 17 men) living with HIV/ AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interferes with ARV therapy regimens. Interviews were transcribed, coded for key themes, and analyzed using grounded theory.

Findings: Food insecurity was common and an important barrier to accessing medical care and ARV …

Associations Between Sport And Screen-Entertainment With Mental Health Problems In 5-Year-Old Children, Lucy J. Griffiths, Marsha Dowda, Carol Dezateux, Russell R. Pate

Faculty Publications

Background: Few studies have examined the benefits of regular physical activity, and risks of sedentary behavior, in young children. This study investigated associations between participation in sports and screen-entertainment (as components of physical activity and sedentary behavior), and emotional and behavioral problems in this population.

Methods: Cross-sectional analysis of data from 13470 children (50.9% boys) participating in the nationally representative UK Millennium Cohort Study. Time spent participating in sports clubs outside of school, and using screen-entertainment, was reported by the child's mother at child age 5 years, when mental health was also measured using the Strengths and Difficulties Questionnaire.

Results …

Policies That Restrict Sweetened Beverage Availability May Reduce Consumption In Elementary-School Children, Sonya J. Jones, Wendy Gonzalez, Edward A. Frongillo Jr.

Faculty Publications

Objective:We investigated whether having a policy regarding the availability of sweetened beverages in school was associated with children's purchase of total weekly and daily consumption of sweetened beverages.

Design: Data were obtained in the Early Childhood Longitudinal Study-Kindergarten cohort. Multilevel logistic regression was used to determine the magnitude and significance of relationships between the availability of different beverages and purchase of sweetened beverages at school and overall consumption of beverages.

Results: The purchase of sweetened beverages by children in school was strongly associated with the administrative policy of sweetened beverage availability. Compared with children in schools without an administrative …

Birth Order Modifies The Effect Of Il13 Gene Polymorphisms On Serum Ige At Age 10 And Skin Prick Test At Ages 4, 10 And 18: A Prospective Birth Cohort Study, Ikechukwu U. Ogbuanu, Wilfried J. Karmaus, Hongmei Zhang, Tara Sabo-Attwood, Susan L. Ewart, Graham Roberts, Syed Hasan Arshad

Faculty Publications

Background: Susceptibility to atopy originates from effects of the environment on genes. Birth order has been identified as a risk factor for atopy and evidence for some candidate genes has been accumulated; however no study has yet assessed a birth order-gene interaction.

Objective: To investigate the interaction of IL13 polymorphisms with birth order on allergic sensitization at ages 4, 10 and 18 years.

Methods: Mother-infant dyads were recruited antenatally and followed prospectively to age 18 years. Questionnaire data (at birth, age 4, 10, 18); skin prick test (SPT) at ages 4, 10, 18; total serum IgE and specific inhalant screen …

Associations Between Polycyclic Aromatic Hydrocarbon-Related Exposures And P53 Mutations In Breast Tumors, Irina Mordukhovich, Pavel Rossner Jr., Mary Beth Terry, Regina M. Santella, Yu-Jing Zhang, Hanina Hibshoosh, Lorenzo Memeo, Mahesh Mansukhani, Chang-Min Long, Gail Garbowski, Meenakshi Agrawal, Mia M. Gaudet, Susan E. Steck, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Kathleen Conway-Dorsey, Marilie D. Gammon

Faculty Publications

BACKGROUND: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology.

OBJECTIVES: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number.

METHODS: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and …

Who Guidelines For Antimicrobial Treatment In Children Admitted To Hospital In An Area Of Intense Plasmodium Falciparum Transmission: Prospective Study, Behzad Nadjm, Ben Amos, George Mtove, Jan Ostermann, Semkini Chonya, Hannah Wangai, Juma Kimera, Walii Msuya, Frank Mtei, Denise Dekker, Rajabu Malahiyo, Raimos Olomi, John A. Crump, Christopher J. M. Whitty, Hugh Reyburn

Faculty Publications

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria.

Design Prospective study.

Setting District hospital in Muheza, northeast Tanzania.

Participants Children aged 2 months to 13 years admitted to hospital for febrile illness.

Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials.

Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum …

Climate Change, Environmental Justice, And Vulnerability: An Exploratory Spatial Analysis, Sacoby M. Wilson, Roland Richard, Lesley Joseph, Edith M. Williams

Faculty Publications

Research has demonstrated that vulnerable populations including disadvantaged populations of color live in areas that may place them at higher risk of exposure to social and environmental hazards. Due to climate change, these populations may experience worse health outcomes and environmental health disparities. The purpose of this project was to explore the use of Geographic Information Systems (GIS) to assess areas that may be vulnerable to climate change across the United States. We employed ArcGIS 9.3 to create vulnerability scores for areas across the country that may be that may be impacted by climate change at the county level in …

Correlates Of Physical Activity In Black, Hispanic, And White Middle School Girls, Evelyn B. Kelly, Deborah Parra-Medina, Karin A. Pfeiffer, Marsha Dowda, Terry L. Conway, Larry S. Webber, Jared B. Jobe, Scott Going, Russell R. Pate

Faculty Publications

Background: A need exists to better understand multilevel influences on physical activity among diverse samples of girls. This study examined correlates of moderate-to-vigorous physical activity (MVPA) among adolescent girls from different racial/ethnic backgrounds. Methods: 1,180 6th grade girls (24.5% black, 15.7% Hispanic, and 59.8% white) completed a supervised self-administered questionnaire that measured hypothesized correlates of PA. MVPA data were collected for 6 days using the ActiGraph accelerometer. Hierarchical regression analysis was used to examine correlates of PA in each racial/ethnic group. Results: Hispanic girls (n=185) engaged in 21.7 minutes of MVPA per day, black girls (n=289) engaged in 19.5 minutes …

It’S Not A Small World After All: Regulating Obesity Globally, Eloisa Rodriguez-Dod

Faculty Publications

The rate of obesity and overweight among the world population has increased dramatically over the past several years in both adults and children. Childhood obesity is a critical health care concern. There have been well-publicized efforts to regulate children‘s obesity both in the U.S. and abroad through such measures as mandated nutritional school lunch programs.

This article focuses, however, on a less examined area of regulation—the recent worldwide efforts to curb obesity among adults. The regulations discussed in this article include measures proposed or adopted by either administrative agencies or legislative bodies, whether on a local or national level. The …

Resting Energy Expenditure Changes With Weight Loss: Racial Differences, Xuewen Wang, Tongjian You, Leon Lenchik, Barbara J. Nicklas

Faculty Publications

It is controversial whether weight loss reduces resting energy expenditure (REE) to a different magnitude in black and white women. This study was to determine whether changes in REE with weight loss were different between black and white postmenopausal women, and whether changes in body composition (including regional lean and fat mass) were associated with REE changes within each race. Black (n= 26) and white (n= 65) women (age= 58.2±5.4 years, 25< BMI< 40 kg·m⁻²) completed a 20-week weight loss intervention. Body weight, lean and fat mass (total body, limb and trunk) via dual energy X-ray absorptiometry, and REE via indirect …

Racial Disparities Between The Sex Steroid Milieu And The Metabolic Risk Profile, Arlette C. Perry, Xuewen Wang, Ronald B. Goldberg, Robert Ross, Loreto Jackson

Faculty Publications

Aims and Method. The present study examined the relationship between the metabolic risk profile (MRP) and total testosterone (TT) and free testosterone using the free androgen index (FAI) and sex hormone binding globulin (SHBG) in 36 Caucasian American (CA) and 30 African-American (AA) women volunteering for a weight loss study. Results. After controlling for age, significant relationships were found between TT and diastolic blood pressure (P = .004 and P = .015 in CA and AA women, resp.). Additionally, total cholesterol (P = .003), low density lipoprotein cholesterol (P = .004), apolipoprotein B (P = .006), …

Metabolic Actions Of Insulin In Men And Women, Faidon Magkos, Xuewen Wang, Bettina Mittendorfer

Faculty Publications

Insulin is an important regulator of glucose, lipid and protein metabolism. It suppresses hepatic glucose and triglyceride production, inhibits adipose tissue lipolysis and whole-body and muscle proteolysis and stimulates glucose uptake in muscle. In this review we discuss what is currently known about the control of substrate metabolism by insulin in men and women. The data available so far indicate that women are more sensitive to insulin with regards to glucose metabolism (both in the liver and in muscle) whereas there are no differences between men and women in insulin action on lipolysis. Potential differences exist in the regulation of …

Volatile Profiling Reveals Intracellular Metabolic Changes In Aspergillus Parasticus: Vea Regulates Branched Chain Amino Acid And Ethanol Metabolism, Ludmila V. Roze, Anindya Chanda, Maris Laivenieks, Randolph M. Beaudry, Katherine A. Artymovich, Anna V. Koptina, Deena W. Awad, Dina Valeeva, Arthur D. Jones, John E. Linz

Faculty Publications

Background: Filamentous fungi in the genus Aspergillus produce a variety of natural products, including aflatoxin, the most potent naturally occurring carcinogen known. Aflatoxin biosynthesis, one of the most highly characterized secondary metabolic pathways, offers a model system to study secondary metabolism in eukaryotes. To control or customize biosynthesis of natural products we must understand how secondary metabolism integrates into the overall cellular metabolic network. By applying a metabolomics approach we analyzed volatile compounds synthesized by Aspergillus parasiticus in an attempt to define the association of secondary metabolism with other metabolic and cellular processes.

Results: Volatile compounds were examined using solid …

Prolonged Injustice In Urban America, Jametta Magwood, Edith M. Williams, Saundra H. Glover

Faculty Publications

Environmental inequality is the suggestion that the working class, the poor, persons of color, and ultimately the economically disadvantaged are subjected to living conditions that may prove to be hazardous both personally, professionally, and also to the infrastructure of the urban communities that these people inhabit. These injustices affect not only housing but education, quality healthcare access, and access to employment. This article investigates the distinct relationship of environmental inequalities imposed in urban communities that are promoted by a prominent institution: the government. It has been suggested that the government is primarily controlled by individuals who are incapable of identifying …

Lessons From A Life Well-Lived, Harold W. Kohl Iii, Steven N. Blair

Faculty Publications

No abstract provided.

Specialty Care Use In Us Patients With Chronic Diseases, Jessica D. Bellinger, Rahnuma M. Hassan, Patrick A. Rivers, Qiang Cheng, Edith M. Williams, Saundra H. Glover

Faculty Publications

Despite efforts to eliminate health disparities, racial, ethnic, and geographic groups continue lag behind their counterparts in health outcomes in the United States. The purpose of this study is to determine variation in specialty care utilization by chronic disease status. Data were extracted from the Commonwealth Fund 2006 Health Care Quality Survey (n = 2475). A stratified minority sample design was employed to ensure a representative sample. Logistic regression was used in analyses to predict specialty care utilization in the sample. Poor perceived health, minority status, and lack of insurance was associated with reduced specialty care use and chronic disease …

Cesarean And Vbac Rates Among Immigrant Vs. Native-Born Women: A Retrospective Observational Study From Taiwan Cesarean Delivery And Vbac Among Immigrant Women In Taiwan, Jung-Chung Fu, Sudha Xirasagar, Jihong Liu, Janice C. Probst

Faculty Publications

Background:Cultural and ethnic roots impact women’s fertility and delivery preferences This study investigated whether the likelihood of cesarean delivery, primary cesarean, and vaginal delivery after cesarean (VBAC) varies by maternal national origin.

Mehods: We conducted a nation-wide, population-based, observational study using secondary data from Taiwan. De-identified data were obtained on all 392,246 singleton live births (≥500 g; ≥20 weeks) born to native-born Taiwanese, Vietnamese and mainland Chinese-born mothers between January 1 2006 and December 31 2007 from Taiwan’s nation-wide birth certificate data. Our analytic samples consisted of the following: for overall cesarean likelihood 392,246 births, primary cesarean 336,766 (excluding …

Trends In Body Fat, Body Mass Index And Physical Fitness Among Male And Female College Students, Peter Pribis, Carol A. Burtnack, Sonya O. Mckenzie, Jerome Thayer

Faculty Publications

There have been many publications in recent years reporting on the quantity of physical activity among college students using indirect indicators such as steps walked per day or time spent on physical activities. The purpose of this study was to describe the trends of physical fitness related to BMI and body fat among university students between 1996 and 2008. The results showed a significant decline in the average fitness levels measured as an estimation of VO2max for male and female students (p < 0.001 for both sexes). The linear trend for BMI by years was not significant for both sexes (p for males = 0.772, p for females = 0.253). On average, in the last 13 years, % body fat was increasing 0.513%/year for males and 0.654%/year for females. There is a significant indirect correlation between the student's VO2max levels and % body fat, r = -0.489; p < 0.001 for males; and r = -0.416, p < 0.001 for females. Approximately 23.9% of the variance in the VO2max levels in males and 17.3% in females can be explained by the variance in % body fat. The results support recent findings that physical fitness among college students is declining and body fatness is increasing. © 2010 by the authors.

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

Prospective Associations Between Objective Measures Of Physical Activity And Fat Mass In 12-14 Year Old Children: The Avon Longitudinal Study Of Parents And Children (Alspac), Chris J. Riddoch, Sam D. Leary, Andy R. Ness, Steven N. Blair, Kevin Deere, Calum Mattocks, Alex Griffiths, George Davey Smith, Kate Tilling

Faculty Publications

Objective: To investigate associations between physical activity at age 12 and subsequent adiposity at age 14.

Design: Prospective birth cohort study with data collected between 2003 and 2007.

Setting: Original recruitment in 1991-2 of 14,541 pregnant women living in the former County of Avon (United Kingdom).

Participants: At age 12, 11,952 children were invited to attend the research clinic. Of these, 7159 attended, and 4150 (1964 boys, 2186 girls) provided sufficient data on exposure, outcome, and confounding variables.

Main outcome measure: Fat mass at age 14, measured by dual emission x ray absorptiometry, associated with physical activity at age 12, …

A Review Of The National Physical Activity Plans Of Six Countries, Daniel B. Bornstein, Russell R. Pate, Michael Pratt

Faculty Publications

Background: Architects of the United States national physical activity plan can benefit from a thorough understanding of national physical activity plans from other nations. The purpose of this paper was to search for and analyze comprehensive national physical activity plan documents that can best inform the development of the U.S. plan. Methods: Electronic databases were searched for national physical activity plan documents, yielding 252 documents from 56 countries. After eliminating documents that were not written in English, did not address physical activity primarily, and did not meet our definition of a national physical activity plan, we were left with physical …

A National Physical Activity Plan For The United States, Russell R. Pate

Faculty Publications

No abstract provided.

A Cost Analysis Of A Physical Activity Intervention For Older Adults, Erik J. Groessl, Robert M. Kaplan, Steven N. Blair, W. Jack Rejeski, Jeffrey A. Katula, Abby C. King, Roger A. Fielding, Nancy W. Glynn, Marco Pahor

Faculty Publications

We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from the "payer's" perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel …

Role Of Lifestyle And Aging On The Longitudinal Change In Cardiorespiratory Fitness, Andrew S. Jackson, Xuemei Sui, James R. Hébert, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF.

Methods - We studied a cohort of 3429 women and 16,889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness …

Quality Health Information On The Internet: Developing A Diabetes Pathfinder For The Chinese Population, Ana D. Cleveland, Jodi Philbrick, Xuequn Pan, Xinyu Yu, Jiangping Chen, Marty O'Neill, Lisa Smith

Faculty Publications

A Web-based bilingual diabetes information pathfinder was created to help the Chinese population access quality health information on the Internet as part of a collaborative outreach project in the Dallas-Fort Worth area. A survey was conducted to identify the demographics, Internet usage, health information needs, and preferences for training sessions of the Chinese population. Breast cancer, diabetes, and hepatitis B were the top three diseases of interest. The process of developing the pathfinder is described from start to finish, and it can serve as a model for the development of others. Pathfinder training sessions also were held. Taylor & Francis …

Sedentary Behavior And Obesity In A Large Cohort Of Children, Jonathan A. Mitchell, Calum Mattocks, Andy R. Ness, Sam D. Leary, Russell R. Pate, Marsha Dowda, Steven N. Blair, Chris Riddoch

Faculty Publications

The purpose of this study was to examine the association between sedentary behavior and obesity among 12-year-old children, while adjusting for moderate-to-vigorous physical activity (MVPA) and other potential confounding variables.

Cross-sectional analyses were carried out with data from 5434 children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC). Fat mass was derived using dual x-ray emission absorptiometry (DXA), and height and weight measurements were used to calculate body mass index (BMI; kg/m²). The children wore an accelerometer for seven days. The cut points for sedentary behavior and MVPA were ≤199 cpm and ≥3600 cpm, …