Public Health Commons^™

Lower Extremity Muscle Strength And Risk Of Self-Reported Hip Or Knee Osteoarthritis, Jennifer M. Hootman, Shannon J. Fitzgerald, Carol A. Macera, Steven N. Blair

Faculty Publications

Purpose: The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).

Methods: Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results: Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip …

Monitoring Physical Activity: Uses And Measurement Issues With Automated Counters, Michelle L. Granner, Patricia A. Sharpe

Faculty Publications

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology …

Sars Surveillance During Emergency Public Health Response, United States, March-July 2003, Stephanie J. Schrag, John T. Brooks, Chris Van Beneden, Umesh D. Parashar, Patricia M. Griffin, Larry J. Anderson, William J. Bellini, Robert F. Benson, Dean D. Erdman, Alexander Klimov, Thomas G. Ksiazek, Teresa C. T. Peret, Deborah F. Talkington, W. Lanier Thacker, Maria L. Tondella, Jacquelyn S. Sampson, Allen W. Hightower, Dale F. Nordenberg, Brian D. Plikaytis, Ali S. Khan, Nancy E. Rosenstein, Tracee A. Treadwell, Cynthia G. Whitney, Anthony E. Fiore, Tonji M. Durant, Joseph F. Perz, Annemarie Wasley, Daniel Feikin, Joy L. Herndon, William A. Bower, Barbara W. Klibourn, Deborah A. Levy, Victor G. Coronado, Joanna Buffington, Clare A. Dykewicz, Rima F. Khabbaz, Mary E. Chamberland

Journal Articles: Epidemiology

In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of …

Muscular Fitness And All-Cause Mortality: Prospective Observations, Shannon J. Fitzgerald, Carolyn E. Barlow, James B. Kampert, James R. Morrow Jr., Allen W. Jackson, Steven N. Blair

Faculty Publications

Background: The beneficial effects of cardiorespiratory fitness on mortality are well known; however, the relation of muscular fitness, specifically muscular strength and endurance, to mortality risk has not been thoroughly examined. The purpose of the current study is to determine if a dose-response relation exists between muscular fitness and mortality after controlling for factors such as age and cardiorespiratory fitness.

Methods: The study included 9105 men and women, 20-82 years of age, in the Aerobics Center Longitudinal Study who have completed at least one medical examination at the Cooper Clinic in Dallas, TX between 1981 and 1989. The exam included …

Physical Activity And Stroke Risk: A Meta-Analysis, Chong Do Lee, Aaron R. Folsom, Steven N. Blair

Faculty Publications

Background and Purpose - Whether physical activity reduces stroke risk remains controversial. We used a meta-analysis to examine the overall association between physical activity or cardiorespiratory fitness and stroke incidence or mortality.

Methods - We searched MEDLINE from 1966 to 2002 and identified 23 studies (18 cohort and 5 case-control) that met inclusion criteria. We estimated the overall relative risk (RR) of stroke incidence or mortality for highly and moderately active individuals versus individuals with low levels of activity using the general variance-based method.

Results - The meta-analysis documented that there was a reduction in stroke risk for active or …

Transmission Of Mycobacterium Tuberculosis Associated With Failed Completion Of Treatment For Latent Tuberculosis Infection - Chickasaw County, Mississippi, June 1999-March 2002, T. Chamblee, D. Hartley, M. Holcombe, K. Parham, P. Upchurch, R. M. Webb, Alyssa G. Robillard, L. Diem, B. Metchock, N. Deluca, P. D. Mcelroy, T. Navin, W. Walton, P. K. Dewan

Faculty Publications

During June 1999-March 2002, a total of 16 tuberculosis (TB) cases were reported from Chickasaw County, Mississippi (2000 population: 19,440), corresponding to annual TB incidences of 20.5-27.6 cases per 100,000 population. In comparison, annual TB incidences for Mississippi during the same period decreased from 7.8 to 5.4 cases per 100,000 population. This report summarizes the results of an investigation of the patients and their contacts and demonstrates the need for strategies to increase the proportion of infection contacts that successfully complete treatment for latent TB infection (LTBI).

Utilization Of Algal And Bacterial Extracellular Polymeric Secretions (Eps) By The Deposit-Feeding Brittlestar Amphipholis Gracillima (Echinodermata), D. L. Hoskins, S. E. Stancyk, Alan W. Decho

Faculty Publications

Like many deposit-feeding organisms, the burrowing brittlestar Amphipholis gracillima feeds on particulate organic matter in surface sediments. Microbial exopolymeric secretions (EPS) are carbohydrate-enriched polymers produced by microalgae and bacteria that bind aggregates and form dense biofilms near the sediment-water interface. EPS are assimilable by some benthic infauna and may be utilized as a significant carbon source. EPS are absorbed by some deposit-feeders, including a holothurian, and may be supplemental sources of nutrition. The burrowing brittlestar A. gracillima is a deposit-feeder that was used in a mass balance approach to model the incorporation of radiolabeled EPS by bottom feeders. Brittlestars were …

Urinary Excretion Of Dithiocarbamates And Selfreported Cruciferous Vegetable Intake: Application Of The ‘Method Of Triads’ To A Foodspecific Biomarker, Jay H. Fowke, James R. Hébert, Jed W. Fahey

Faculty Publications

Objective: Greater intake of Cruciferous vegetables (e.g. broccoli) may prevent cancer at several sites. Urinary excretion of isothiocyanate conjugates (dithiocarbamates, DTC) provides a specific biomarker of Cruciferous vegetable consumption suitable for epidemiological investigations. However, no gold-standard referent is available for evaluating urinary DTC levels as an estimator of Cruciferous vegetable consumption. We compared urinary DTC levels to intake as measured by two selfreported dietary assessment techniques. Design: Cruciferous vegetable consumption was measured before and after a behavioural dietary intervention using multiple 24-hour recalls (24HR), a foodcounting questionnaire (VFQ) and urinary DTC excretion levels. Analysis included a structural equation approach (Method …

Associations Between Cardiorespiratory Fitness And C-Reactive Protein In Men, Timothy S. Church, Carolyn E. Barlow, Conrad P. Earnest, James B. Kampert, Elisa L. Priest, Steven N. Blair

Faculty Publications

Objective - This study examined the association between cardiorespiratory fitness and C-reactive protein (CRP), with adjustment for weight and within weight categories.

Methods and Results - We calculated median and adjusted geometric mean CRP levels, percentages of individuals with an elevated CRP (≥2.00 mg/L), and odds ratios of elevated CRP across 5 levels of cardiorespiratory fitness for 722 men. CRP values were adjusted for age, body mass index, vitamin use, statin medication use, aspirin use, the presence of inflammatory disease, cardiovascular disease, and diabetes, and smoking habit. We found an inverse association of CRP across fitness levels (P for …

Aha Guidelines For Primary Prevention Of Cardiovascular Disease And Stroke: 2002 Update - Consensus Panel Guide To Comprehensive Risk Reduction For Adult Patients Without Coronary Or Other Atherosclerotic Vascular Diseases, Thomas A. Pearson, Steven N. Blair, Stephen R. Daniels, Robert H. Eckel, Joan M. Fair, Stephen F. Fortmann, Barry A. Franklin, Larry B. Goldstein, Philip Greenland, Scott M. Grundy, Yuling Hong, Nancy Houston-Miller, Ronald M. Lauer, Ira S. Ockene, Ralph L. Sacco, James F. Sallis, Sidney C. Smith Jr., Neil J. Stone, Kathryn A. Taubert

Faculty Publications

No abstract provided.

Prevention Conference Vi: Diabetes And Cardiovascular Disease - Writing Group Iii: Risk Assessment In Persons With Diabetes, Rita F. Redberg, Philip Greenland, Valentin Fuster, Kalevi Pyörälä, Steven N. Blair, Aaron R. Folsom, Anne B. Newman, Daniel H. O'Leary, Trever J. Orchard, Bruce Psaty, J. Sanford Schwartz, Rodman D. Starke, Peter W. F. Wilson

Faculty Publications

No abstract provided.

Dietary Exposures And Oral Precancerous Lesions In Srikakulam District, Andhra Pradesh, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, Hemali Mehta, Wei Zheng, Maureen Sanderson, Jane Teas

Faculty Publications

Objective: To test the effect of dietary nutrients on oral precancerous lesions in a reverse-smoking (i.e. smoking with the glowing end inside the mouth) population in South India. Design: Case–control. Cases with precancerous lesions were matched to an equal number of lesion-free controls matched on age (^5 years), sex and village. All subjects used tobacco in some form. Dietary data were obtained using an intervieweradministered food-frequency questionnaire, designed for use in this population. All interviews were conducted blinded to the disease status of the subject. Data were analysed using logistic regression. Setting: Nineteen rural villages in Srikakulam District, Andhra Pradesh. …

Descriptive Epidemiology Of Body Mass Index Of An Urban Adult Population In Western India, H. C. Shukla, P. C. Gupta, H. C. Mehta, James R. Hébert

Faculty Publications

Study objective: To describe height, weight, and body mass index (BMI) of the adult urban population in Mumbai, western India and to estimate the prevalence and severity of thinness and overweight in this population. To describe the association of BMI with education, age, and tobacco habits in an urban Indian population. Design: Cross sectional representative survey of 99 598 adults (40 071 men and 59 527 women). Setting: The survey was carried out in the city of Mumbai (formerly known as Bombay) in western India. Participants: Men and women aged >35 years who were residents of the main city of …

Aha/Acc Guidelines For Preventing Heart Attack And Death In Patients With Atherosclerotic Cardiovascular Disease: 2001 Update - A Statement For Healthcare Professionals From The American Heart Association And The American College Of Cardiology, Sidney C. Smith Jr., Steven N. Blair, Robert O. Bonow, Lawrence M. Brass, Manuel D. Cerqueira, Kathleen Dracup, Valentin Fuster, Antonio M. Gotto, Scott M. Grundy, Nancy Houston-Miller, Alice Jacobs, Daniel Jones, Ronald M. Krauss, Lori Mosca, Ira S. Ockene, Richard C. Pasternak, Thomas A. Pearson, Marc A. Pfeffer, Rodman K. Starke, Kathryn A. Taubert

Faculty Publications

No abstract provided.

The Kentucky Plan: An Innovative Approach To Professional Doctoral Education In Public Health., Joel M. Lee, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The Doctor of Public Health (Dr.P.H.) degree is designed to prepare graduates for the highest levels of leadership in public health related careers in both public and private settings. The Kentucky School of Public Health has developed an innovative generalist professional degree program offering an extensive battery of courses based on the body of professional public health knowledge. The degree includes extensive supervised field experience as part of the academic training, linking theory with practice. Issues related to professional degrees, curriculum, accreditation and certification, admission, evaluation, plans for institutional cooperation, and demand are addressed.

Proteolytic Enzymes In The Marine Bacterium Pseudoalteromonas Atlantica: Post-Secretional Activation And Effects Of Environmental Conditions, Monica Hoffman, Alan W. Decho

Faculty Publications

Production and activities of cellular and extracellular proteolytic enzymes associated with the marine bacterium Pseudoalteromonas atlantica were examined in response to physiological state and changing environmental variables under laboratory conditions. Enzymes evidenced by zymography were metalloproteases, as defined by substrate preference and susceptibility to inhibitors (EDTA and 1, 10-phenanthroline). Distinct bands (i.e. molecular-weight [MW] size classes) of enzymes were isolated from within cellular and extracellular compartments. Susceptibility of extracellular enzymes to environmental stressors was related, in part, to the MW size classes of the enzymes. While all bands of enzymes showed some degree of inhibition when pH was decreased, the …

Comparison Of A Dietary Record Using Reported Portion Size Versus Standard Portion Size For Assessing Nutrient Intake, Desiree C. Welten, Ruth A. Carpenter, R. Sue Mcpherson, Suzanne Brodney, Deirdre Douglass, James B. Kampert, Steven N. Blair

Faculty Publications

Objective: Because the percentage of missing portion sizes was large in the Aerobics Center Longitudinal Study (ACLS), careful consideration of the accuracy of standard portion sizes was necessary. The purpose of the present study was to investigate the consequences of using standard portion size instead of reported portion sizes on subjects' nutrient intake.

Methods: In 2307 men and 411 women, nutrient intake calculated from a 3-day dietary record using reported portion sizes was compared with nutrient intake calculated from the same record in which standard portion sizes were substituted for reported portion sizes.

Results: The standard portion sizes provided significantly …

Low Fasting Plasma Glucose Level As A Predictor Of Cardiovascular Disease And All-Cause Mortality, Ming Wei, Larry W. Gibbons, Tedd L. Mitchell, James B. Kampert, Michael P. Stern, Steven N. Blair

Faculty Publications

Background - Although medical textbooks usually classify fasting plasma glucose <70 or 80 mg/dL (<3.89 or 4.44 mmol/L) as abnormal, the prognosis for patients with low fasting plasma glucose is unclear.

Methods and Results - We conducted prospective cohort studies among 40,069 men and women to investigate the association between fasting plasma glucose levels and cardiovascular disease and all-cause mortality. We documented a U-shaped relation between fasting plasma glucose and mortality. In addition to diabetes and impaired fasting glucose levels, low fasting plasma glucose levels were also associated with high morality. After multivariate adjustment for age, sex, study population, ethnicity, current smoking status, high blood pressure, total cholesterol, body mass index, triglycerides, history of cardiovascular disease and cancer, and a family …

Trends. Controlling Aids Through Control, Ibpp Editor

International Bulletin of Political Psychology

This article discusses the concept of political control and public health in the context of the HIV/AIDS epidemic.

How Tuberculosis Threatens Supporters And Opponents Of Racial Profiling, Ibpp Editor

International Bulletin of Political Psychology

This article explores peculiarities of logic and reason among supporters and opponents of racial profiling as a tool of developing and implementing public policy.

Cardiovascular Disease Prevention By Sports: Myth Or Reality?, Maria João C. A. Almeida, Steven N. Blair

Faculty Publications

Low levels of physical activity and fitness substantially increase risk of several chronic diseases, reduce longevity, and lead to loss of function. The strength and relation of inactivity to health problems and the high prevalence of sedentary habits in most countries of the world make lack of exercise a major public health problem. Fortunately, there is now good consensus regarding public health recommendations for physical activity from many important medical, scientific, and public health organizations. Recent research on physical activity interventions provides additional approaches to helping sedentary adults become more physically active.

Dietary Assimilation Of Cadmium Associated With Bacterial Exopolymer Sediment Coatings By The Estuarine Amphipod Leptocheirus Plumulosus: Effects Of Cd Concentration And Salinity, Christian E. Schlekat, Alan W. Decho, G. Thomas Chandler

Faculty Publications

Bacterial extracellular substances (also known as exopolysaccharides, or EPS) may serve as vectors for trophic transfer of metals in benthic systems because these ubiquitous sediment coatings can sorb high concentrations of toxic metals, and because many benthic invertebrates assimilate EPS sediment coatings upon ingestion. We conducted 3 sets of experiments to determine the assimilative bioavailability of EPS-associated Cd to the benthic amphipod Leptocheirus plumulosus as a function of Cd concentration and salinity. Bioavailability was measured as L. plumulosus Cd assimilation efficiency (AE) from EPS-coated silica (EPS●Si) and from uncoated silica (NC●Si) using modified pulse-chase methods with the gamma-emitting radioisotope ^{109 …}

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Gujarat, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, Pesi N. Sinor, Hemali Mehta, Fali S. Mehta

Faculty Publications

Objective: To develop and test a quantitative, interviewer-administered food frequency questionnaire (FFQ) to ascertain nutrient intakes of individuals in northern India. Design: A 92-item FFQ was developed based on food use and market surveys of the study area. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 6 randomly selected days over 1 year. Two FFQs were administered, one each at the beginning and end of the 1-year period. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by computing differences between nutrient intakes estimated by the two methods. Setting: Rural villages …

Development And Testing Of A Quantitative Food Frequency Questionnaire For Use In Kerala, India, James R. Hébert, Prakash C. Gupta, Ramesh B. Bhonsle, P. R. Murti, Hemali Mehta, Florence Verghese, Mira Aghi, Kamala Krishnaswamy, Fali S. Mehta

Faculty Publications

Objective: To develop and test a food frequency questionnaire (FFQ) for use in rural areas of Kerala, India. Design: Based on food use and market surveys of the study area, a quantitative 81- item interviewer-administered FFQ was developed. A validation study was conducted consisting of 24-h diet recalls (24HR) administered on 8 days randomly selected over an entire year and two administrations of the FFQ, one at the beginning of the l-year period and the other at the end. FFQ and 24HR-derived nutrient scores were compared using correlation and regression analyses and by examining differences in the nutrient scores. Setting: …

Managing Household Hazardous Waste Or Making A Choice To Do Something Without Going Broke, Maine State Planning Office

Maine Collection

Managing Household Hazardous Waste Or Making a Choice to Do Something Without Going Broke

State of Maine, State Planning Office, Augusta, Maine

Androscoggin Valley Council of Governments, Auburn, Maine

August 1995.

Contents: Acknowledgements / Abbreviations / Introduction / I. History of Household Hazardous Waste in Maine / II. How-To Guide for Towns / Appendixes / Bibliography

Aging And Exercise: A Health Perspective, Joanna L. Bokovoy, Steven N. Blair

Faculty Publications

Habitual exercise provides protection against fatal coronary heart disease, extends longevity, and enhances quality of life. National surveys show less physical activity in older men and women compared with middle-aged and younger persons; older women are particularly sedentary. Although there are still few longitudinal studies on exercise and physical activity in older individuals, the data support a positive relationship between physical activity and health function in older individuals. The data further show that with regular physical activity, health and fitness are maintained or even increased over time in older individuals. Studies on physical activity requirements for beneficial health effects in …

Humic And Fulvic Acids: Sink Or Source In The Availability Of Metals To The Marine Bivalves Macoma Balthica And Potamocorbula Amurensis?, Alan W. Decho, Samuel N. Luoma

Faculty Publications

Humic acids (HA) and fulvic acids (FA) are common forms of organic matter in marine sediments, and are routinely ingested by deposit- and suspension-feeding animals. These compounds may be a sink for metals, implying that once metals are bound to humic substances they are no longer available to food webs. A series of experiments was conducted to quantitatively examine this premise using 2 estuarine bivalves from San Francisco Bay, USA: the suspension feeder Potarnocorbula arnurensis and the facultative deposit feeder Macoma balthica. HA and FA, isolated from marine sediments, were bound as organic coatings to either hydrous ferric oxides …

Physical Inactivity. Workshop V. Aha Prevention Conference Iii. Behavior Change And Compliance: Keys To Improving Cardiovascular Health, Steven N. Blair, Kenneth E. Powell, Terry L. Bazzarre, James L. Early, Leonard H. Epstein, Lawrence W. Green, Sally S. Harris, William L. Haskell, Abby C. King, Jeffrey Koplan, Bess H. Marcus, Ralph S. Paffenbarger Jr., Kimberly K. Yeager

Faculty Publications

No abstract provided.

Statement On Exercise: Benefits And Recommendations For Physical Activity Programs For All Americans - A Statement For Health Professionals By The Committee On Exercise And Cardiac Rehabilitation Of The Council On Clinical Cardiology, American Heart Association, Gerald F. Fletcher, Steven N. Blair, James Blumenthal, Carl Caspersen, Bernard Chaitman, Stephen Epstein, Harold Falls, Erika S. Sivarajan Froelicher, Victor F. Froelicher, Ileana L. Piña

Faculty Publications

No abstract provided.

Time-Courses In The Retention Of Food Material In The Bivalves Potamocorbula Amurensis And Macoma Balthica: Significance To The Absorption Of Carbon And Chromium, Alan W. Decho, Samuel N. Luoma

Faculty Publications

Time courses for ingestion, retention and release via feces of microbial food was investigated using 2 bivalves with different feeding strategies, Potamocorbula amurensis, and Macoma balthica. The results showed 2 pathways for the uptake of food material in these clams. The first is represented by an initial label pulse in the feces. The second pathway operates over longer time periods. Inert ⁵¹Cr-labeled beads were used to determine time frames for these pathways. The first pathway, involving extracellular digestion and intestinal uptake, is relatively inefficient in the digestion of bacterial cells by P. amurensis but more efficient in …