Jessica L. Thomson

Development of a Direct Observation Instrument to Measure Environmental Characteristics of Parks for Physical Activity

BACKGROUND The studys purpose is to describe the development and evaluate the reliability (inter-observer agreement) and validity (rater agreement with a gold standard) of a direct observation instrument to assess park characteristics that may be related to physical activity. METHODS A direct observation instrument of 181 items was developed based on a conceptual model consisting of the following domains: features, condition, access, esthetics, and safety. Fifteen pairs of observers were trained and sent to two parks simultaneously to assess two Target Areas each. RESULTS Overall domain reliability was 86.9%, and overall geographic area reliability was 87.5%. Overall domain validity was 78.7% and overall geographic area validity was 81.5%. CONCLUSIONS Inter-rater reliability and validity were generally good, although validity was slightly lower than reliability. Objective items showed the highest reliability and validity. Items that are time-sensitive may need to be measured on multiple occasions, while items asking for subjective responses may require more supervised practice.

Factors associated with delays to diagnosis and treatment of breast cancer in women in a Louisiana urban safety net hospital.

Only lung cancer surpasses breast cancer as a cause of death from cancer. However, the burden of cancer is not borne equally across racial and ethnic groups. In the United States, African American women have significantly higher mortality rates from breast cancer than white women. Delayed follow-up of breast abnormalities and delays from diagnosis to treatment may contribute to higher mortality. This study examined factors associated with delays to diagnosis and treatment of breast cancer in a group of white and African American women. Identified from tumor registry records were 247 women with pathology-confirmed first primary in situ and invasive breast carcinomas with no known previous cancer diagnosis. Factors associated with delays from provider recognition of abnormality to breast cancer diagnosis (diagnostic delays) and from diagnosis to treatment (treatment delays) were determined using chi-square tests and logistic regression. Factors that were considered included age, race, stage of disease at diagnosis, tumor size, type of abnormality, type of medical service at presentation, and prior mammogram within the past two years. The proportion of women experiencing diagnostic delays was high, with more African American women experiencing delays than white women (34% versus 17%, respectively). African American and white women did not differ in distribution of stage of cancer at diagnosis. Significantly smaller tumor sizes were found in women experiencing diagnostic delays compared to those not experiencing delays. Conversely, women experiencing treatment delays were significantly older and had larger tumor sizes compared to those not experiencing delays. More African American women experienced delays in diagnosis; however these delays did not appear to affect outcomes. Older age as a significant factor in treatment delays suggests that comorbidities as well as other possible barriers to treatment warrant further investigation in older women. The reasons for racial disparities in breast cancer outcomes remain and call for further study.

Advanced glycation end-products in sickle cell anaemia.

Tissue accumulation of advanced glycation end‐products (AGEs) has been implicated in the oxidant‐induced vascular pathology of diabetes and other diseases. Because homozygous sickle cell anaemia (SCA) is a state of oxidative stress, we tested the hypothesis that circulating AGE levels are elevated in SCA. Blood was obtained from age‐ and race‐matched children classified as either non‐sickle cell controls, SCA without vaso‐occlusive crisis (SCA − VOC), or SCA with vaso‐occlusive crisis (SCA + VOC). Plasma and red blood cell (RBC) AGE levels were measured by immunoassay. RBC levels of reduced (GSH) and oxidized (GSSG) glutathione were measured by capillary electrophoresis as an indicator of endogenous antioxidant status. The results showed that plasma AGE levels and the rate of RBC AGE accumulation were significantly higher in patients with SCA compared with controls. GSH was not different between groups but was significantly inversely correlated with plasma AGEs in both controls and patients with SCA. GSSG was significantly lower and GSH/GSSG higher in SCA + VOC patients, suggesting that GSH/GSSG might be an objective indicator of acute VOC or a risk factor for VOC. We conclude that circulating AGE levels are strongly influenced by endogenous antioxidant status and may play a role in the vascular pathology of SCA.

Children in School Cafeterias Select Foods Containing More Saturated Fat and Energy than the Institute of Medicine Recommendations

In this study, we examined if childrens food selection met the School Meals Initiative (SMI) standards and the recently released Institute of Medicine (IOM) recommendations. Mean food selection, plate waste, and food intake were also examined. Food intake of 2049 4th-6th grade students was measured objectively at lunch over 3 d with digital photography in 33 schools. The percent of children whose food selection met the SMI standards and IOM recommendations for energy (kJ), fat and saturated fat, calcium, iron, and vitamin A and C were calculated. The SMI standards provide lower limits for most nutrients; the IOM provides a range of values, including an upper limit for energy. Seventy-seven percent of childrens energy selection met the SMI lower limit, but only 16% of children met the IOMs recommended range and 74% of children exceeded the upper limit. More than 70% of children exceeded the SMI and IOMs saturated fat recommendations. Children selected (mean +/- SD) 3168 +/- 621 kJ, discarded 882 +/- 581 kJ, and consumed 2286 +/- 716 kJ. Children were less likely to discard fat than carbohydrate, resulting in proportionally more fat being consumed. Most children met SMI and IOM recommendations for protein, calcium, iron, and vitamin A. With few exceptions, energy selection was similar among groups of children, but plate waste differed (P < 0.001), resulting in greater energy intake among boys compared with girls, Caucasians compared with African Americans, and heavier compared with lighter children. Childrens selection was high in saturated fat and, based on IOM criteria, included excess energy.

Unraveling the Impact of Nitrogen Nutrition on Cooked Rice Flavor and Texture

ABSTRACT Understanding the influences of amylose and protein contents on rice sensory properties is key to maintaining quality and providing consumers with rice with desired flavor and textural attributes. This research focused on delineating the effects of nitrogen nutrition on cooked rice texture and flavor. The sensory properties of cultivars grown in adjoining fields with differing rates of nitrogen fertilizer (to yield grains with a large spread in protein contents) were measured by a panel trained in descriptive analysis. Second, rice sensory properties were modeled using apparent amylose and protein data. Fertilizer level affected protein and apparent amylose contents and, in turn, cooked rice texture. Protein contents were significantly higher (P < 0.0007) and apparent amylose contents were significantly lower (P < 0.0001) at the higher fertilizer level. Models revealed a negative correlation of protein content with initial starchy coating, slickness, and stickiness between grains—three attributes...

A Church-Based Diet and Physical Activity Intervention for Rural, Lower Mississippi Delta African American Adults: Delta Body and Soul Effectiveness Study, 2010–2011

Introduction Obesity, diabetes, and hypertension have reached epidemic levels in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a 6-month, church-based diet and physical activity intervention, conducted during 2010 through 2011, for improving diet quality (measured by the Healthy Eating Index-2005) and increasing physical activity of African American adults in the LMD region. Methods We used a quasi-experimental design in which 8 self-selected eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Statistical tests for group comparisons included χ2, Fisher’s exact, and McNemar’s tests for categorical variables, and mixed-model regression analysis for continuous variables and modeling intervention effects. Results Retention rates were 85% (176 of 208) for control and 84% (163 of 195) for intervention churches. Diet quality components, including total fruit, total vegetables, and total quality improved significantly in both control (mean [standard deviation], 0.3 [1.8], 0.2 [1.1], and 3.4 [9.6], respectively) and intervention (0.6 [1.7], 0.3 [1.2], and 3.2 [9.7], respectively) groups, while significant increases in aerobic (22%) and strength/flexibility (24%) physical activity indicators were apparent in the intervention group only. Regression analysis indicated that intervention participation level and vehicle ownership were significant positive predictors of change for several diet quality components. Conclusion This church-based diet and physical activity intervention may be effective in improving diet quality and increasing physical activity of LMD African American adults. Components key to the success of such programs are participant engagement in educational sessions and vehicle access.

Subcutaneous Adipose Tissue from Obese and Lean Adults Does Not Release Hepcidin In Vivo

Hepcidin is the main regulator of systemic iron homeostasis and is primarily produced by the liver but is also expressed, at the mRNA-level, in periphery tissues including the subcutaneous and visceral adipose tissue. Obesity is associated with elevated hepcidin concentrations and iron depletion suggesting that the exaggerated fat mass in obesity could contribute significantly to circulating hepcidin levels consequently altering iron homeostasis. The objective of this study was to determine if abdominal subcutaneous adipose tissue (AbScAT) releases hepcidin in vivo and if release is modified by obesity. Arterio-venous differences in concentrations of hepcidin were measured across AbScAT in 9 obese and 9 lean adults. Overall (n = 18), mean plasma hepcidin concentrations were significantly higher in arterialized compared to AbScAT venous samples [mean difference (arterialized-AbScAT venous plasma hepcidin) = 4.9 ± 9.6 ng/mL, P = 0.04]. Net regional release was not calculated because mean venous plasma hepcidin concentrations were lower than mean arterialized concentrations indicating no net release. Significant correlations between AbScAT venous and arterialized plasma hepcidin concentrations with anthropometric variables were not observed. Findings from this vein drainage study suggest there is no net release of hepcidin from the AbScAT depot and thereby no ability to signal systemically, even in obesity.

HUB city steps: a 6-month lifestyle intervention improves blood pressure among a primarily African-American community.

The effectiveness of community-based participatory research (CBPR) efforts to address the disproportionate burden of hypertension among African Americans remains largely untested. The objective of this 6-month, noncontrolled, pre-/post-experimental intervention was to examine the effectiveness of a CBPR intervention in achieving improvements in blood pressure, anthropometric measures, biological measures, and diet. Conducted in 2010, this multicomponent lifestyle intervention included motivational enhancement, social support provided by peer coaches, pedometer diary self-monitoring, and monthly nutrition and physical activity education sessions. Of 269 enrolled participants, 94% were African American and 85% were female. Statistical analysis included generalized linear mixed models using maximum likelihood estimation. From baseline to 6 months, blood pressure decreased significantly: mean (± standard deviation) systolic blood pressure decreased from 126.0 ± 19.1 to 119.6 ± 15.8 mm Hg, P=0.0002; mean diastolic blood pressure decreased from 83.2 ± 12.3 to 78.6 ± 11.1 mm Hg, P<0.0001). Sugar intake also decreased significantly as compared with baseline (by approximately 3 tsp; P<0.0001). Time differences were not apparent for any other measures. Results from this study suggest that CBPR efforts are a viable and effective strategy for implementing nonpharmacologic, multicomponent, lifestyle interventions that can help address the persistent racial and ethnic disparities in hypertension treatment and control. Outcome findings help fill gaps in the literature for effectively translating lifestyle interventions to reach and engage African-American communities to reduce the burden of hypertension.

Lateralization of temporal lobe epilepsy and learning disabilities, as defined by disability-related civil rights law.

Summary:  Purpose: Epilepsy research has identified higher rates of learning disorders in patients with temporal lobe epilepsy (TLE). However, most studies have not adequately assessed complex functional adult learning skills, such as reading comprehension and written language. We designed this study to evaluate our predictions that higher rates of reading comprehension, written language, and calculation disabilities would be associated with left TLE versus right TLE.

Food and Beverage Choices Contributing to Dietary Guidelines Adherence in the Lower Mississippi Delta

OBJECTIVES The objectives of the present study were to evaluate diet quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005) and to identify the top five dietary sources contributing to HEI-2005 components. Demographic differences in HEI-2005 scores were also explored. DESIGN Diet quality was evaluated using HEI-2005. Demographic differences in HEI-2005 scores were investigated using multivariable regression models adjusting for multiple comparisons. The top five dietary sources contributing to HEI-2005 components were identified by estimating and ranking mean MyPyramid equivalents overall and by demographic characteristics. SETTING Dietary data, based on a single 24 h recall, from the Foods of Our Delta Study 2000 (FOODS 2000) were used in the analyses. SUBJECTS FOODS 2000 adult participants 18 years of age or older. RESULTS Younger age was the largest determinant of low diet quality in the LMD with HEI-2005 total and seven component scores declining with decreasing age. Income was not a significant factor for HEI-2005 total or component scores. The top five dietary sources differed by all five of the demographic variables, particularly for total vegetables and energy from solid fats, alcoholic beverages and added sugars (SoFAAS). Soft drinks were the leading source of SoFAAS energy intake for all demographic groups. CONCLUSIONS The assessment of diet quality and identification of top dietary sources revealed the presence of demographic differences for selected HEI-2005 components. These findings allow identification of food patterns and culturally appropriate messaging and highlight the difficulties of treating this region as a homogeneous population.