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PubMed1999

Assays for noninvasive imaging of reporter gene expression.

Repeated, noninvasive imaging of reporter gene expression is emerging as a valuable tool for monitoring the expression of genes in animals and humans. Monitoring of organ/cell transplantation in living animals and humans, and the assessment of environmental, behavioral, and pharmacologic modulation of gene expression in transgenic animals should soon be possible. The earliest clinical application is likely to be monitoring human gene therapy in tumors transduced with the herpes simplex virus type 1 thymidine kinase (HSV1-tk) suicide gene. Several candidate assays for imaging reporter gene expression have been studied, utilizing cytosine deaminase (CD), HSV1-tk, and dopamine 2 receptor (D2R) as reporter genes. For the HSV1-tk reporter gene, both uracil nucleoside derivatives (e.g., 5-iodo-2'-fluoro-2'-deoxy-1-beta-D-arabinofuranosyl-5-iodouracil [FIAU] labeled with 124I, 131I) and acycloguanosine derivatives [e.g., 8-[18F]fluoro-9-[[2-hydroxy-1-(hydroxymethyl)ethoxy]methyl]guanine (8-[18F]-fluoroganciclovir) ([18F]FGCV), 9-[(3-[18F]fluoro-1-hydroxy-2-propoxy)methyl]guanine ([18F]FHPG)] have been investigated as reporter probes. For the D2R reporter gene, a derivative of spiperone [3-(2'-[18F]-Fluoroethyl)spiperone ([18F]FESP)] has been used with positron emission tomography (PET) imaging. In this review, the principles and specific assays for imaging reporter gene expression are presented and discussed. Specific examples utilizing adenoviral-mediated delivery of a reporter gene as well as tumors expressing reporter genes are discussed.

Animals↗

PubMed2004

Quantitative source identification of dioxin-like PCBs in Yokohama, Japan, by temperature dependence of their atmospheric concentrations.

The source and environmental behavior of dioxin-like polychlorinated biphenyls (PCBs) together with other PCBs and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/PCDFs) were evaluated based on analysis of variations in their atmospheric concentrations in Yokohama, Japan. Potential factors responsible for variations in the atmospheric concentrations of the congeners were investigated by principal component analysis and multiple regression analysis of the data. Two major variations were seen: one had strong temperature dependence, while the other had no significant temperature dependence. A possible explanation for this difference is that the former is related to congeners released by volatilization (e.g., volatilization from commercial PCB products and past polluted environments), while the latter is related to congeners emitted from thermal processes. The relative contributions of dioxin-like PCBs released by volatilization and those emitted from thermal processes were estimated based on the temperature dependence of the atmospheric concentrations. The results suggest that both dioxin-like PCBs emitted from thermal processes and those released by volatilization are significant sources of air pollution in this area in terms of the toxic equivalent (TEQ) for dioxin-like PCBs. We demonstrated that the present approach based on variations in atmospheric concentrations can be useful in providing a qualitative as well as quantitative understanding of source information.

Air Pollutants↗

PubMed2006

Biodegradation and product identification of [14C]hexabromocyclododecane in wastewater sludge and freshwater aquatic sediment.

In a previous study the biodegradation of hexabromocyclododecane (HBCD) was reported to occur under realistic environmental concentrations in soils and freshwater aquatic sediments with biotransformation half-lives ranging from approximately 2 days to 2 months. In this study we extend our knowledge as to the environmental behavior of HBCD with respect to the fate of the three major diastereomers of HBCD (alpha, beta, and gamma) as well as to the identification of major intermediate metabolites formed during degradation. Substantial biological transformation of the alpha-, beta-, and gamma-[14C]HBCD diastereomers was observed in wastewater (i.e., digester) sludge and in freshwater aquatic sediment microcosms prepared under aerobic and anaerobic conditions. Concomitant with the loss of [14C]HBCD in these matrixes there was a concurrent production of three [14C]products. Using a combination of high performance liquid chromatography atmospheric pressure photoionization mass spectrometry and gas chromatography electron impact ionization mass spectrometry these metabolites were identified as tetrabromocyclododecene, dibromocyclododecadiene, and cyclododecatriene. We propose that HBCD is sequentially debrominated via dihaloelimination where at each step there is the loss of two bromines from vicinal carbons with the subsequent formation of a double bond between the adjacent carbon atoms. These results demonstrate that microorganisms naturally occurring in aquatic sediments and anaerobic digester sludge mediate complete debromination of HBCD.

Carbon Radioisotopes↗

PubMed2002

Illness causal attributions: an exploratory study of their structure and associations with other illness cognitions and perceptions of control.

Two studies were conducted to investigate the cognitive organization and psychological meaning of illness causes. Using a direct similarity judgment method (Study 1), illness causes were found cognitively organized in a hierarchical configuration that could meaningfully be represented as a tree with three main branches--environmental, behavioral, and hidden causes--that further divided into subcategories. This classification of illness causes was associated with other components of the illness schema, namely, the consequences and control/cure dimensions, but not with timeline perceptions (Study 2). Perceptions of control were significantly associated with the cognitive organization of illness causal attributions. Personal relevancy was found as a moderator of illness causal attributions, influencing the relationships between attributions and other illness cognitions.

Adult↗

PubMed1985

Insulin levels, hunger, and food intake: an example of feedback loops in body weight regulation.

The paper reviews studies considering whether hyperinsulinemia, and its resultant effects on adipose tissue mass, can alter perceived hunger, taste, and food consumption. It also describes work addressing the reciprocal question of whether cues associated with food can affect insulin response. Specifically, four general categories of studies are presented. First, studies considering the causes and physiological consequences of chronic hyperinsulinemia are reviewed. Second, work investigating environmental and cognitive influences on insulin secretion are described. These show that high acute levels of insulin can be produced by simply seeing and thinking about food and that individuals showing this response show a greater tendency toward weight gain in a food-abundant environment. Third, studies are covered in which direct manipulations of insulin level, controlling for blood glucose, are performed. These experiments show that elevations in insulin produce increased hunger, heightened perceived pleasantness of sweet taste, and increased food intake. Finally, a study is described that considers how different insulin levels, produced by the type of food ingested, may affect subsequent food intake. Together, these studies show that "overeating" is caused by a complex feedback system of environmental, behavioral, and biological factors.

Appetite Regulation↗

PubMed2001

Treatment approaches: food first for weight management and health.

Many genetic, environmental, behavioral, and cultural factors affect health. Diet is as vital as any of them for preventing disease and promoting well-being. We know that what we eat can lead to premature disability and mortality: to obesity, coronary heart disease, type 2 diabetes, degenerative arthritis, sleep apnea, and other illnesses. Now scientific evidence points to links between dietary patterns and illness. The study of these links is a new approach to understanding the role that diet plays in chronic disease. Initial studies include those on eating patterns and risk of colon cancer. More recently, researchers have investigated all-cause mortality and leading causes of chronic disease. Novel epidemiological approaches include factorial analysis to evaluate dietary patterns and cluster analysis to examine nutrient intake, gender, and weight status across food-pattern clusters. These methods work best within groups to identify major dietary patterns, but not necessarily ideal diets. They may also differ across population groups. The success of the Dietary Approaches to Stop Hypertension and Lyon Diet Heart studies supports the value of dietary pattern analysis. At the same time, the relative failure of single-nutrient studies underscores the need for new methodologies and directions in research.

Body Weight↗

PubMed2002

The obesity epidemic: pathophysiology and consequences of obesity.

Obesity has reached epidemic proportions in the United States: more than 20% of adults are clinically obese as defined by a body mass index of 30 kg/m(2) or higher, and an additional 30% are overweight. Environmental, behavioral, and genetic factors have been shown to contribute to the development of obesity. Elevated body mass index, particularly caused by abdominal or upper-body obesity, has been associated with a number of diseases and metabolic abnormalities, many of which have high morbidity and mortality. These include hyperinsulinemia, insulin resistance, type 2 diabetes, hypertension, dyslipidemia, coronary heart disease, gallbladder disease, and certain malignancies. This underscores the importance of identifying people at risk for obesity and its related disease states.

Adipose Tissue↗

PubMed1987

Development of the communication profile for the hearing impaired.

The rehabilitative needs of hearing-impaired adults depend on the degree of communication handicap experienced and on many other factors (environmental, behavioral, emotional, and attitudinal) that contribute to communication problems. The Communication Profile for the Hearing Impaired (CPHI) is a 145-item self-assessment inventory for adults. Its 25 scales encompass four areas: Communication Performance, Communication Environment, Communication Strategies, and Personal Adjustment. The inventory was developed at Walter Reed Army Medical Center and pilot tested over a 3-year period on 827 patients who attended the Aural Rehabilitation Program at the Army Audiology and Speech Center. The rationale and methods used to develop the CPHI are discussed, and normative data for the Walter Reed population are presented.

Adult↗

PubMed1996

Agitation: Subtypes and Their Mechanisms.

Agitation includes inappropriate verbal, vocal, or motor behaviors that, in the opinion of an observer, do not result directly from the needs or confusion of the agitated individual. Those behaviors affect the well-being of older persons and their caregivers, and therefore also the care rendered to the older person, including the likelihood of institutionalization. The inappropriate nature of agitated behavior is judged from the standpoint of an observer rather than that of the agitated person and may be subject to bias. Research to help clinicians disentangle the meaning of agitation and reduce the effects of observer bias has produced an approach to classification that is useful as a starting point. Agitated behaviors can be divided into physical and verbal, aggressive and non-aggressive. The available literature suggests that the different agitated behaviors have different meanings. Most seem to be associated with discomfort, which may include physical pain, external restraint, or feelings of depression or of loneliness. In contrast, some of the behaviors, especially in the physically nonaggressive category, may be adaptive and not an indication of discomfort. Other behaviors may result directly from neurological damage. On the basis of these interpretations of the reasons for disruptive behaviors, several approaches for treatment follow logically. Although there is much literature on behavioral, environmental, social, and pharmological approaches to treatment of agitation, large well-designed studies are conspicuously lacking. Both good intervention studies and improved methods for tailoring treatment to the specific needs and background of individual elderly persons are needed to better treat this complex phenomenon.

Journal Article↗

PubMed2002

[Bariatric surgery -- stereotypes and paradigms].

Many physicians regard obesity as a sin and treat fat patients with disdain befitting a moral leper. Non-bariatric physicians, being a product of our culture, seem more likely to have an obesity paradigm close to that of the public. Many members of the public regard obesity surgery as dangerous. Many insurers reject morbid obese patients from bariatric surgical treatment with the paradigmal statement that obesity is totally the fault of a fat person. These medical experts do not accept obesity as a disease (which WHO does) and therefore social courts also reject applications of patients who want to undergo bariatric surgery. Morbid obesity is a multifactorial problem with genetic, biochemical, hormonal, environmental, behavioral and cultural elements. It is recognized as an extreme health hazard which is rarely the result of an aberrant moral problem or true addictive behavior. We need to change effectively the negative paradigms towards obesity and its surgery from some of our colleagues, hospital administration, medical insurers and the public. The existing prejudices are not acceptable.

Attitude of Health Personnel↗

PubMed2004

Assessing professionalism: a review of the literature.

Although assessing professionalism poses many challenges, gauging and detecting changes in professionalism is impossible without measurement. This paper is a review of techniques used to assess professionalism during the past 20 years. The authors searched five electronic databases and reference lists from 1982 to 2002. Eighty-eight assessments were retained and organized into content area addressed (i.e. ethics, personal characteristics, comprehensive professionalism, diversity) and type of outcome examined (i.e. affective, cognitive, behavioral, environmental). Instead of creating new professionalism assessments, existing assessments should be improved. Also, more studies on the predictive validity of assessments and their use as part of formative evaluation systems are recommended. Based on the review, suggestions are presented for assessing medical students, resident physicians and practicing physicians.

Educational Measurement↗

PubMed2000

Cancer Prevention and Control Training Program at the University of Alabama at Birmingham.

The pre- and postdoctoral Cancer Prevention and Control Training Program (CPCTP) at the University of Alabama at Birmingham (UAB) has attracted high-quality trainees from all over the United States. The trainees have pursued courses of study in epidemiology, nutrition sciences, health behavior, environmental health sciences, biostatistics, or public health nutrition; and research projects in cessation of tobacco use, cancer screening, cancer epidemiology, diet modification, nutrient-cancer relationships, statistical modeling of carcinogenesis, medical-nutrition education, and obesity, in precise alignment with NCI cancer control objectives. Both courses and research projects have been interdisciplinary, taking advantage of the strong interdepartmental collaborative atmosphere at UAB. Former trainees have been successfully placed in academic, administrative, and practice positions in which they can strategically apply their cancer prevention and control expertise.

Adult↗

PubMed2004

Preventing alcohol-related traffic injury: a health promotion approach.

The conditions that give rise to drinking and driving are complex, with multiple and interrelated causes. Prevention efforts benefit from an approach that relies on the combination of multiple interventions. Health promotion provides a useful framework for conceptualizing and implementing actions to reduce drinking and driving since it involves a combination of educational, behavioral, environmental, and policy approaches. This review draws on data from a range of settings to characterize the effectiveness of various interventions embedded within the health promotion approach. Interventions considered part of the health promotion approach include: (1) economic interventions (2) organizational interventions, (3) policy interventions, and (4) health education interventions, including the use of media, school and community education, and public awareness programs. Effective health promotion strengthens the skills and capabilities of individuals to take action and the capacity of groups or communities to act collectively to exert control over the determinants of alcohol-impaired driving. There is strong evidence for the effectiveness of some components of health promotion, including economic and retailer interventions, alcohol taxation, reducing alcohol availability, legal and legislative strategies, and strategies addressing the servers of alcohol. There is also evidence for the effectiveness of sobriety checkpoints, lower BAC laws, minimum legal drinking age laws, and supportive media promotion programs. Other interventions with moderate evidence of effectiveness include restricting alcohol advertising and promotion, and actions involving counter advertising. Health education interventions alone that have insufficient evidence for effectiveness include passive server training programs, school drug and alcohol education programs, community mobilization efforts, and health warnings. Because each intervention builds on the strengths of every other one, ecological approaches to reducing alcohol-impaired driving using all four components of the health promotion model are likely to be the most effective. Settings such as schools, workplaces, cities, and communities offer practical opportunities to implement alcohol-impaired driving prevention programs within this framework.

Accidents, Traffic↗

PubMed2006

Declining vulnerability to temperature-related mortality in London over the 20th century.

The degree to which population vulnerability to outdoor temperature is reduced by improvements in infrastructure, technology, and general health has an important bearing on what realistically can be expected with future changes in climate. Using autoregressive Poisson models with adjustment for season, the authors analyzed weekly mortality in London, United Kingdom, during four periods (1900-1910, 1927-1937, 1954-1964, and 1986-1996) to quantify changing vulnerability to seasonal and temperature-related mortality throughout the 20th century. Mortality patterns showed an epidemiologic transition over the century from high childhood mortality to low childhood mortality and towards a predominance of chronic disease mortality in later periods. The ratio of winter deaths to nonwinter deaths was 1.24 (95% confidence interval (CI): 1.16, 1.34) in 1900-1910, 1.54 (95% CI: 1.42, 1.68) in 1927-1937, 1.48 (95% CI: 1.35, 1.64) in 1954-1964, and 1.22 (95% CI: 1.13, 1.31) in 1986-1996. The temperature-mortality gradient for cold deaths diminished progressively: The increase in mortality per 1 degree C drop below 15 degrees C was 2.52% (95% CI: 2.00, 3.03), 2.34% (95% CI: 1.72, 2.96), 1.64% (1.10, 2.19), and 1.17% (95% CI: 0.88, 1.45), respectively, in the four periods. Corresponding population attributable fractions were 12.5%, 11.2%, 8.7%, and 5.4%. Heat deaths also diminished over the century. There was a progressive reduction in temperature-related deaths over the 20th century, despite an aging population. This trend is likely to reflect improvements in social, environmental, behavioral, and health-care factors and has implications for the assessment of future burdens of heat and cold mortality.

Adolescent↗

PubMed2000

Overweight and underweight coexist within households in Brazil, China and Russia.

The possibility that underweight and overweight coexist within households and understanding such an occurrence have not been studied sufficiently. In fact, underweight and overweight are thought of as resulting from very different environmental, behavioral and individual risk factors. This study identified households in which overweight and underweight coexist and explored household-level associations such as urban residence and income. Using three large national surveys from Brazil, China and Russia, the prevalence of such households ranged from 8% in China and Russia to 11% in Brazil. Even more important from the public health perspective is the finding that these under/over households accounted for a high proportion of all households with an underweight member in China (23%), Brazil (45%), and Russia (58%). The prevalence of the underweight/overweight household was highest in the urban environment in all three countries. There was no clear pattern in the prevalence of the underweight/overweight household type by income. Multivariable logistic regression was used to test the significance of the association of household type with urban residence and income while controlling for household size and household demographics by gender. Further analysis was done to consider the age relationships within the underweight/overweight pair. The underweight child coexisting with an overweight nonelderly adult was the predominant pair combination in all three countries. These findings illustrate the need for public health programs that are able to address underweight and overweight simultaneously.

Age Factors↗

PubMed1996

Calculation procedure of potential alpha energy concentration with continuous air sampling.

A continuous potential alpha energy concentration monitor was developed to estimate the lung dose for inhalation of radon progeny. A silicon semiconductor detector was used as a detector. The build-up method was used and alpha particles emitted from 218Po, 214Po, 212Bi, and 212Po were detected. As 218Po and 212Bi have alpha particles of nearly the same energy, three detecting channels were set up. Counts corresponding to each nuclide were sent to a printer every 30 min. For the purpose of determining the potential alpha energy concentration of radon progeny continuously, a proper calculation procedure was investigated in detail. With this method, 218Po concentration and potential alpha energy concentration of radon progeny could be continuously obtained. The potential alpha energy concentration based on this procedure agreed well with that calculated from individual radon progeny concentration. When the measurement was done at 30-min intervals, the minimum detectable concentrations of 218Po concentration and equilibrium equivalent radon concentration were 0.3 Bq m(-3) and 0.15 Bq m(-3), respectively. The monitor can be used not only to estimate the lung dose but also to analyze environmental behavior of radon progeny.

Air Pollution, Radioactive↗

PubMed1999

Lung cancer epidemiology and genetics.

Lung cancer is the number one cause of cancer death for all citizens of the United States regardless of gender, race, or ethnic background. Surgery, the only curative treatment available, is feasible in only 35% of all patients with lung cancer. But even in this group of patients, most will die of recurrent disease. Treatment advances have been modest at best, and the 5-year survival rate of approximately 15% has not changed appreciably in the past two decades. Population projections indicate a continuation of the lung cancer epidemic among men and a rise among women, in whom rates of smoking have remained relatively high. It is estimated that 90% of all lung cancers are smoking related, and gender, race, and family history are important risk modifiers. Several promising markers of lung cancer susceptibility have recently been identified. However, the relative contribution of individual intrinsic factors (genetic markers, family history, race, gender) on lung cancer susceptibility in the context of complex extrinsic factors (behavior, environmental exposure, socioeconomic status) is unknown and requires further study for more informed screening and primary prevention.

Female↗

PubMed1998

Factors associated with adult periodontitis in a dental teaching clinic population.

Exposure to a number of environmental, behavioral and sociodemographic variables has been associated with increased prevalence and severity of adult periodontitis. However, it is not possible easily to identify the individuals most susceptible to this chronic disease. A case control study was conducted among a population of adults to determine what factors were associated with increased prevalence of moderate to advanced periodontitis. Clinical and radiographic data were obtained from dental charts and structured interviews were conducted by telephone to collect sociodemographic and behavioral data. Statistical modeling was completed for the total study population (35-87-year-olds) and for two age-stratified subpopulations. Significant crude disease associations were observed between periodontitis and numerous explanatory variables. However, after adjustment for age and gender, few variables remained significant. Age stratification indicated that young adults (35-54 years) were affected differently from older adults (> or =55 years) by exposures to certain variables. Young moderate smokers had a 3.15 times increased risk of periodontitis and young heavy smokers had a 7.33 times increased risk compared to never-smokers. Older single adults had a 3.07 times increased risk compared to those with partners.

Adult↗