|| Type 2 Diabetes and Three Calpain-10 Gene Polymorphisms in Samoans
|| Mother/Grandmother Heart Disease Prevention Program
||The Effect of Dietary Freeze-Dried Blueberries on N-Nitrosomethylbenzylamine-Induced Tumorigenesis in the Rat Esophagus
||Does Size Really Matter? The Relationship of Size and Weight to Neonatal Morbidity and Mortality
||The Value Maps of Older South Carolinians: What Matters Most When Making Long-Term Care Decisions?
||Impact of Maternal Birthplace on Major Congenital Malformations in New York Hispanics
||Environmental Enrichment Reverses Cognitive and Molecular Deficits Induced by Developmental Lead Exposure
||Assessing the Impact of Breast Cancer Risk Factors on Women in Utah
||Trends in Racial Disparities in U.S. Birth Weigh-Gestational Age Specific Infant Mortality
||Muscle Torque, Velocity and Power: The Effects of Age
||Schools for Healthy Lifestyles: A Quanititative Evaluation
Type 2 Diabetes and Three Calpain-10 Gene Polymorphisms in Samoans
Hui-Ju Tsai, Department of Human Genetics, University of Pittsburgh
Other Authors: Guangyun Sun, Daniel E. Weeks, Stephen T. McGarvey, Ritesh Kaushal, Michael Wolujewicz and Ranjan Deka
Type 2 diabetes is a major public health problem and a common disease that affects ~135 million people on a global scale. Although genome-wide scans have identified several chromosomal susceptibility regions, finding a causative gene has remained an enigma. A previous study has reported a novel gene, calpain-10, located on chromosome 2q37.3, as a putative susceptibility gene. Three single nucleotide polymorphisms (SNP43, SNP19, SNP63) were shown to be involved in increased risk of disease among Mexican Americans. In this study, we analyzed the association of these three polymorphisms with type 2 diabetes in Samoans. We computed allele frequencies for three SNPs, then tested if there was a significant difference between controls and cases by a contingency c2 test. Haplotype frequencies were estimated by the EM algorithm implemented in the programs EH, ZAPLO and PHASE. Linkage disequilibrium was evaluated for each pairwise comparison in cases and controls. We calculated the standardized disequilibrium coefficient and the delta-squared measure of disequilibrium for each pair of the SNPs. The association of each pairwise comparison was tested by Fisher's exact test. For association analyses, we used a nonparametric test T5 statistic to test if haplotype frequencies were significantly different between cases and controls.
In our sample consisting of 96 controls and 176 cases, there is no significant evidence of association between cases and controls in allele frequencies, haplotype frequencies or haplotype combinations of three SNPs. Also, there is no evidence of linkage in the region of chromosome 2 containing these three SNPs.
desire for a better life and job provide additional insights into their lives. These findings, and their relevance for health literacy, will be discussed.
Mother/Grandmother Heart Disease Prevention Program
Donna L. Milavetz, MD, University of Minnesota
Other Authors: Margaret McLaughlin, PhD; Wanda Alexander RN, MPH, and Lynn Blewett, PhD
Cardiovascular disease is a major public health problem affecting approximately 500,000 women annually.(1) Minority women have a disproportionate burden of disease relative to Caucasian women. Although much research is focused on etiologic mechanisms, the foundation for any disease treatment is prevention. The conventional office-based counseling approach to risk reduction in women has not been successful, particularly among minority populations. We hypothesize that using a gender sensitive, community-based mother/grandmother-daughter partnership will be a more successful cardiovascular prevention program for minority women.
We hypothesize that women are motivated to change health behaviors that their children perceive are important, and that the dialogue and time with their children fosters social support. We also predict that if the participants create the design of this program, the immediate and long-term success will be greater. We hope to identify variables associated with limitations in attaining healthy behaviors in women.
We will outline a theoretical model to support this hypothesis as well as a plan for developing the program. The model consists of data collection on health perception and program design for the following groups: daughters, mothers/grandmothers, community health advisory group, and the community health clinic where the program will be implemented. We will then analyze the data to find common variables between groups on which to build the program design.
We report the first phase of data collection and analysis of the “daughter” group using teen health educators in an urban public high school to gain insight into their realities of what health and prevention are, and variables that might prevent them and their mothers/grandmothers from leading a more healthy life.
The Effect of Dietary Freeze-Dried Blueberries on N-Nitrosomethylbenzylamine-Induced Tumorigenesis in the Rat Esophagus
Robeena M. Aziz, Ohio State University School of Medicine and Public Health
Other Authors: Ron Nines, Kapila Rodrigo, Keith Harris, Tamaro Hudson, Ashok Gupta, Mark Morse, Peter Carlton and Gary D. Stoner
Previous studies in our laboratory have demonstrated the inhibitory effects of freeze-dried strawberries and black raspberries on N-nitrosomethylbenzylamine (NMBA)-induced tumorigenesis in the rat esophagus. In addition, organic extracts from strawberries and black raspberries were shown to inhibit benzo[a]pyrene-induced transformation of Syrian hamster embryo (SHE) cells in vitro. In the present study, we evaluated blueberries for their ability to inhibit NMBA tumorigenesis in the rat esophagus. Blueberries, like strawberries and black raspberries, contain multiple cancer preventive agents, and are among the most heavily consumed berries in the American diet. They differ from strawberries and black raspberries however, in that they contain only small amounts of the chemopreventive agent, ellagic acid. Two weeks prior to NMBA treatment, animals were placed on a control diet or diets containing 5 and 10% freeze-dried blueberries. NMBA treatment was once per week for 15 weeks. At 25 weeks, 5% and 10% blueberries produced no significant differences in tumor incidence or size when compared to NMBA-treated controls. In addition, blueberries did not reduce the formation of NMBA-induced O6-methylguanine adducts in esophageal DNA when fed at 10% of the diet. Blueberries therefore, appear to lack components that influence the metabolism of NMBA into DNA damaging species.
Does Size Really Matter? The Relationship of Size and Weight to Neonatal Morbidity and Mortality
Meredith Tabangin, Eastern Virginia Medical School Graduate Program in Public Health
Previous studies suggest numerous factors that contribute to neonatal morbidity and mortality. Examining size and weight and their relationship to neonatal morbidity and mortality may be one link to improving infant health. The study objective was to assess relationships between the following characteristics: 1) prenatal care and birthweight; 2) prenatal care and intrauterine growth restriction (IUGR); 3) birthweight and survival; and 4) IUGR and survival, in a neonatal intensive care unit (NICU) population.
This prospective cohort study included 572 infants admitted in 2000 to the NICU in an urban children's hospital in Norfolk , Virginia . Data was collected from computerized transcriptions of hospital medical records. Chi-square tests for independence were used to correlate each predictor and outcome.
Infants born to mothers with minimal or no prenatal care had a 33% increased risk of low birthweight compared to infants born to mothers with routine prenatal care [Risk ratio (RR): 1.33, 95% confidence interval (CI): 1.15,1.55]. Low birthweight infants who were also pre-term had a 12% decreased risk of survival, whereas low birthweight, full term infants had a 6% increased risk of survival, when compared to infants with normal birthweight [RR: 0.8927, CI: 0.8361, 0.9352] and [RR: 1.069, CI: 1.030,1.111], respectively. This evidence supports findings that prenatal care helps reduce infant morbidity and mortality. Future studies may examine other characteristics of growth and growth restriction and other variables that affect neonatal morbidity and mortality in order to help plan and implement more efficient and effective intervention programs.
The Values Maps of Older South Carolinians : What Matters Most When Making Long-Term Care Decisions?
Katherine H. Leith, University of South Carolina
Research shows that health professionals frequently assume they understand the value systems of their older patients. To design and deliver responsive long-term care (LTC) services, health planners and professionals must appreciate the values important to older adults. We examined three values potentially affecting the LTC decisions of older adults.
Secondary data analysis was performed on a cross-sectional telephone survey of persons ages 65+ living in South Carolina . Responses of 454 older adults to 15 value items were subject to factor analysis. Multivariate analysis was used to determine how socio-demographic factors influence the perceived importance of underlying values.
Factor analysis revealed three underlying values, “socialization,” “autonomy,” and “aging in place” (Cronbach's alphas of .74, .74, and .55, respectively). The importance assigned to autonomy and socialization varied little across socio-demographic factors. Both autonomy and socialization were significantly more important to men than to women. Respondents in poor health valued socialization more than respondents in good or very good health. The importance assigned to aging in place was affected by several socio-demographic factors. Non-white respondents, and respondents who had never been married, with a college degree, and with private insurance all assigned greater importance to this value. Older respondents varied less across socio-demographic factors with regard to autonomy and socialization than was expected. These values appear to be so fundamental that they are intrinsic to ALL older South Carolinians . Health professionals must be sensitive to the importance of these values when assisting older adults with their LTC decisions.
Impact of Maternal Birthplace on Major Congenital Malformations in New York Hispanics
Motao Zhu, University at Albany SUNY
Other Authors: C.M. Druschel and S. Lin
The study objectives were to examine the relationship between maternal birthplace and major congenital malformations among Hispanics. This s tudy is one of the few research studies to document Hispanic subgroups, and combine maternal and paternal birthplace. Data was derived from the New York State (NYS) Congenital Malformations Registry (CMR) and Birth Certificates (BC). Cases were live born singleton infants with major birth defects born to NYS resident Hispanic mothers reported to CMR from 1983 to 1997. Controls were randomly selected live born singleton births without major birth defects from BC. Logistic regression was used to adjust for paternal Spanish origin, maternal education, maternal age, maternal residence, prenatal care utilization, and infant's sex.
For overall congenital malformations, the adjusted odds ratio (aOR) comparing US-born to foreign-born mothers was 1.13 with 95% confidence interval (CI): 1.08-1.19. Compared with US-born mothers, the aORs for mothers born in Central or Southern America, and Cuba were 0.84 and 0.74 respectively. There was no additive effect when combining maternal and paternal birthplace. US-born mothers showed positive association with cardiovascular defects (aOR 1.17, 95% CI 1.09-1.26), genitournary defects (aOR 1.12, 95% CI 1.02-1.22), musculoskeketal defects (aOR 1.14, 95% CI 1.02-1.28), clefts (aOR 1.25, 95% CI 1.06-1.47), and tetralogy of Fallot (aOR 1.31, 95% CI 1.02-1.68). US-born Hispanic mothers had higher risk to deliver live born singleton infants with major congenital malformations than foreign-born Hispanic mothers.
Environmental Enrichment Reverses Cognitive and Molecular Deficits Induced by Developmental Lead Exposure
Christopher D. Toscano, Johns Hopkins University Bloomberg School of Public Health
Other Authors: J.L. McGlothan, S.A. Weaver and T.R. Guilarte
We have previously described that rats exposed to lead during gestation and lactation until weaning, exhibit deficits in spatial learning as young adults. Using this exposure protocol, we set out to determine if environmental enrichment (EE) altered the learning and molecular deficits induced by developmental exposure to lead. At weaning, male rats from control or lead-exposed litters were randomly assigned to isolated or EE housing. Rats were reared under these conditions until the end of spatial learning testing. Lead-exposed rats reared in isolation were markedly impaired in the acquisition of the spatial learning task at 50 days of age. However, lead- exposed rats reared in EE cages learned the spatial learning task as well as control EE rats. Recovery of learning performance in lead-exposed EE rats was associated with recovery of NMDA receptor (NMDAR) subunit 1 mRNA deficits and enhanced NMDAR levels in the hippocampus. Further, lead-exposed EE rats exhibited increased hippocampal expression of the nerve growth factor, brain-derived neurotrophic factor (BDNF). These findings demonstrate for the first time that cognitive and molecular deficits resulting from developmental exposure to lead are reversible by providing a social and enriched environment. Our studies provide a new direction for the treatment of children with cognitive deficits resulting from environmental exposure to lead. [This work was supported by NIEHS grant # ES0619 to TRG and CDT is supported by NIEHS training grant # ES07141.]
Assessing the Impact of Breast Cancer Risk Factors on Women in Utah
Melissa Christensen, University of Utah
Breast cancer is the leading cancer diagnosis and second leading cause of cancer mortality in the United States . Among states, Utah exhibits comparatively low breast cancer incidence and mortality rates. During 1994-1998, SEER (Surveillance Epidemiology and End Results) reported Utah as having the lowest age-adjusted incidence rate (97.8 per 10^5 py) and second lowest mortality rate (20.6 per 10^5py) among its eleven US registries.
Utah 's low rates likely reflect lifestyle choices within the population. 70% of the population belongs to the Church of Jesus Christ of Latter-Day Saints (LDS). A marked difference exists between breast cancer rates in LDS and non-LDS women. When broken down by religious status, non-LDS breast cancer rates approach national levels; LDS rates drop further below state rates. LDS teachings emphasizing families and proscribing alcohol consumption may explain this difference as they influence major breast cancer risk factors such as parity, breast feeding practices, use of oral contraceptives, age at first birth, and alcohol use.
Through literature review, known breast cancer risk factors and associated relative risks have been identified. A 38-item statewide telephone survey based on this review will determine risk factor prevalence and religious status among 1000 Utah women. Pegus Research, a local surveying firm, will conduct the survey via random digit dialing. Previously unquantified prevalence differences between LDS and non-LDS will be identified. Prevalences and relative risks may be combined to compute etiologic fractions (proportion of disease burden due to specific risk factors) which will improve understanding of the forces reducing breast cancer burdens in Utah.
Trends in Racial Disparities in U.S. Birth Weight-Gestational Age Specific Infant Mortality
Deren E. Bader, CPM, MPH, University of Alabama at Birmingham , Department of Maternal and Child Health, School of Public Health.
We examined temporal changes in birth weight-gestational age (BW-GA) specific infant mortality for African-American (A-A) and White race groups. We also calculate the number of annual excess A-A infant deaths. Live births to U.S. resident mothers with a reported maternal race of White or A-A were selected from the National Center for Health Statistics' linked live birth-infant death cohort files (1985-1987 and 1995-1997). We compared racial differences in the distributions of live births and infant deaths. We calculated ratios of BW-GA specific IMRs between the race groups. Excess annual A-A infant deaths were calculated by comparing the observed distribution of infant deaths to a weighted distribution of deaths. The weighted distribution represents the expected number of deaths based on the proportion of all U.S. births among A-As (15.4%).
A-As have a higher proportion of low birth weight (LBW) and preterm infants. The percent of White LBW infants is rising, while the disparity in IMRs between Whites and A-As is increasing. Among preterm births, racial disparities in survival are decreasing. Whites experienced greater gains in survival for preterm and LBW infants and an increased advantage in mortality near term. A-As experience almost 2 times more then the expected number of infant deaths. Improved survival of White preterm, and LBW infants, and the growing survival gap between A-A and White in term births has contributed to the increasing racial disparity. Efforts will need to focus on explaining why A-As have higher rates of mortality among term and postterm infants.
Muscle Torque, Velocity and Power: The Effects of Age
Ian R. Lanza, University of Massachusetts , Amherst
Human skeletal muscle contraction speed slows with age. The impact of this slowing on the torque-velocity and power-velocity relationships is not fully understood. To compare these relationships in functionally distinct muscle groups, the ankle dorsiflexors and knee extensors were studied. Subjects performed maximal voluntary concentric contractions (MVCs) at pre-set target velocities using an isokinetic They also performed isometric MVCs at regular increments throughout the same range of motion used for isovelocity trials. To account for differences in strength across subjects, the torque-velocity relationship was expressed relative to maximal isometric torque. Time to target velocity was longer in older subjects in the dorsiflexors (p=0.01), but not in the knee extensors (p=0.12). Older subjects produced less torque at all velocities for both dorsiflexors (p=0.05) and knee extensors (p<0.001). Peak power was lower in older subjects for both dorsiflexors (p=0.01) and knee extensors (p=0.005), particularly at higher velocities, demonstrating a progressive impairment in muscle function as contraction velocity increases. These results are functionally important as activities of daily living rely heavily on dynamic contractions of varying velocities.
Schools for Healthy Lifestyles: A Quantitative Evaluation
Rebekah R. Rhoades, University of Oklahoma College of Public Health
Other Authors: Laura A. Beebe, PhD and Wendy J. Jones, MPH
Schools for Healthy Lifestyles (SHL) is an innovative, community-based health promotion program targeting elementary school children and families, as well as faculty and staff. The program focuses on physical activity and fitness, and prevention of cardiovascular disease, cancer, and injury.
The objective of the study was t o quantitatively evaluate the impact of the SHL program on student knowledge and fitness levels. A pre-post design with a non-randomized comparison group was utilized. Data were collected at two points in time during the 2000-01 school year. Five of the 19 SHL schools were randomly selected as the intervention group and matched with a non-participating comparison school. Active parental consent was obtained from 710 participating fourth and fifth graders. A questionnaire assessed knowledge, attitudes, and behaviors surrounding the priority health concerns. The Fitnessgram program was used to measure physical fitness levels.
A greater increase in health related knowledge was observed among students attending SHL schools. A 92.3% increase among SHL students answering at least three-fourths of the questions correctly was observed compared to a 51.2% increase among comparison students. Additionally, the percentage of comparison students that reported having ever tried cigarettes increased 140%, from 5.8% to 13.9%. In contrast, the percentage (10.6%) of SHL students reporting the same did not change from pre to post-testing. However, results regarding physical fitness were highly variable. Curriculum should be standardized and include required elements to be implemented at all participating schools. Furthermore, resources should be focused on improving program quality within schools that consistently surpass the minimum criteria.