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Introduction Many demographic and metabolic factors contribute to cardiovascular disease (CVD). Recently, systemic inflammation was proposed to be a new risk factor for CVD. The common carotid artery intima-media thickness (IMT) was found... more
Introduction Many demographic and metabolic factors contribute to cardiovascular disease (CVD). Recently, systemic inflammation was proposed to be a new risk factor for CVD. The common carotid artery intima-media thickness (IMT) was found to be a reliable and valid marker of CVD. We analyzed the relationship between IMT and clinical contributors including demographic and metabolic variables and an inflammatory marker, C-reactive protein (CRP). Methods As a part of our ongoing prospective study of job stress on CVD, a group of 88 non-hypertensive (BP < 140/90 mm Hg), clinically healthy young professionals (average 33 years old) were analyzed. Common carotid artery IMT was measured by ultrasonography (HP Sono 5500) and analyzed with IôDP software. Multivariable linear regression was used to analyze the association between IMT and demographic factors (age, gender, ethnicity, work shift, smoking history, waist circumference), metabolic modulators (fasting glucose, HDL, LDL, and non-HDL levels) and an inflammatory marker (CRP). Results We found that IMT was significantly associated with smoking history, age, ethnicity, LDL, fasting glucose and CRP levels. After adjusting for all of these demographic and metabolic factors, the inflammatory marker CRP level remained significantly positively associated with IMT. Summary Our results suggest that both traditional risk factors including smoking, age, ethnicity, hypercholesterolemia and insulin resistance as well as the newly proposed systemic inflammation contribute to the early development of CVD. The sub-clinical inflammatory marker CRP is an independent risk factor of CVD in the apparently healthy, non-hypertensive young professionals.
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Research Interests: Cognitive Science, Psychiatry, Mental Health, Epilepsy, Adolescent, and 15 moreMedicine, Humans, Female, Male, Psychological Intervention, Checklist, Mental Disorders, Mental health services, Mental Disorder, Middle Aged, Adult, Cross Sectional Studies, Neurosciences, Psychiatric Status Rating Scales, and mass Screening
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Epidemic levels of obesity, diabetes, hypertension, and heart disease are rampant in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a six-month, church-bas...
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Background. The purpose of this study was to collect updated school food service purchasing practices from K-12 public school food service directors (SFSD) in Mississippi and to determine their current abilities, experiences, and desires... more
Background. The purpose of this study was to collect updated school food service purchasing practices from K-12 public school food service directors (SFSD) in Mississippi and to determine their current abilities, experiences, and desires to engage in Farm to School (F2S) activities. Methods. The online survey was created using questionnaire items from existing F2S surveys. The survey opened in October 2021 and closed in January 2022. Descriptive statistics were used to summarize the data. Results. Of the 173 SFSD sent email invitations, 122 (71%) completed the survey. The most common fresh fruit and vegetable purchasing practices included Department of Defense Fresh Program (65%) and produce vendor (64%). Forty-three percent of SFSD purchased at least one locally sourced fruit and 40% purchased at least one locally sourced vegetable, while 46% did not purchase any locally sourced foods. The most common challenges for purchasing from farmers included no relationship with farmers (50%...
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The study’s purpose was to determine small farm product amounts and seasonality and examine spatial relationships between small farms and K-12 public schools in Mississippi. Online survey participation invitations were sent via email to... more
The study’s purpose was to determine small farm product amounts and seasonality and examine spatial relationships between small farms and K-12 public schools in Mississippi. Online survey participation invitations were sent via email to farmers and school food service directors from October 2021 to January 2022. Data were summarized using descriptive statistics and proximities between farms (n = 29) and schools (n = 122) determined using spatial analysis. Median yearly amounts for both fresh fruits and vegetables ranged from 1–50 to 201–500 pounds while other product amounts ranged from 1–50 to >1000 pounds. Fresh fruits, fresh vegetables, and other product seasonality ranged from 1 to 6 months, 1 to 12 months, and 3 to 12 months, respectively. In total, 8 out of 12 fresh fruits, 24 out of 25 fresh vegetables, and all other products were harvested during the academic school year. Fifty percent of the schools were within a 20-mile radius of at least one small farm, while 98% were ...
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Objectives Using a single question to assess an individual's diet quality could reduce researcher burden when screening potential participants for dietary interventions. Thus, the purpose of this study was to determine if United... more
Objectives Using a single question to assess an individual's diet quality could reduce researcher burden when screening potential participants for dietary interventions. Thus, the purpose of this study was to determine if United States (US) adults can accurately assess the quality of their diet. Methods Data from two cycles of National Health and Nutrition Examination Survey (NHANES), 2015–2016 and 2017–2018, were used for this study. Self-assessed diet quality was measured with a single question asking adults, aged ≥20 years, how healthy is your diet? The five responses included excellent, very good, good, fair, and poor. Measured diet quality was assessed using the 2015 Healthy Eating Index (HEI-2015) and based on 24-hour dietary recalls. HEI-2015 total scores were categorized using a 10-point grading scale as A (90–100), B (80–89), C (70–79), D (60–69) and F (0–59). The following matches between self-assessed and measured diet quality were classified as accurate assessments: ...
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Purpose To estimate the percentage of United States adults who accurately assessed their diet quality (DQ). Design Observational, cross-sectional, nationally representative. Setting National Health and Nutrition Examination Survey,... more
Purpose To estimate the percentage of United States adults who accurately assessed their diet quality (DQ). Design Observational, cross-sectional, nationally representative. Setting National Health and Nutrition Examination Survey, 2015-2018. Sample 9757 (86%) of 11 288 adults aged ≥20 years. Measures Perceived DQ was assessed by asking participants, how healthy is your diet? The five responses included excellent, very good, good, fair, and poor. Measured DQ was assessed using 24-hours dietary recalls scored with 2015 Healthy Eating Index; scores were categorized using a 10-point grading scale. Analysis Matches between perceived and measured DQ that were classified as accurate included: excellent = A, very good = A or B, good = B or C, fair = C or D, and poor = D or F. All others were classified as inaccurate. Analyses included descriptive statistics and multivariable logistic regression for complex survey designs. Results 63% of adults perceived their DQ as very good or good while ...
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Additional file 2: Supplementary Table 2. Overall fit statistics for latent class models of parent- and child-reported JS parenting practices. Table contains model fit statistics for the latent class analysis using 1–6 latent classes and... more
Additional file 2: Supplementary Table 2. Overall fit statistics for latent class models of parent- and child-reported JS parenting practices. Table contains model fit statistics for the latent class analysis using 1–6 latent classes and based on the 12 parenting practices (6 parent-reported and 6 child-reported) included in the FLASHE surveys.
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Background To date, Healthy Eating Index 2015 (HEI-2015) scores have not been published in the peer-reviewed literature for nationally representative samples of American children. Objective The aim of this study was to use the HEI-2015 to... more
Background To date, Healthy Eating Index 2015 (HEI-2015) scores have not been published in the peer-reviewed literature for nationally representative samples of American children. Objective The aim of this study was to use the HEI-2015 to describe the diet quality of American children overall and within various sociodemographic populations. Design We used 3 cycles of NHANES dietary data sets (2009–2010, 2011–2012, and 2013–2014) to calculate HEI-2015 total and component scores by use of the population ratio method for children aged 2–18 y (n = 9000). Diet-quality scores were computed overall and by age (2–5, 6–11, and 12–18 y), gender, race or ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race), and family poverty-to-income ratio (below or at or above the poverty threshold). HEI-2015 mean total and component scores were computed along with 95% CIs. Results The HEI-2015 total mean score for children overall was 54.9 (range: 0–100). As ...
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Background. Improving the diet of communities experiencing health inequities can be challenging given that multiple dietary components are low in quality. Mississippi Communities for Healthy Living was designed to test the comparative... more
Background. Improving the diet of communities experiencing health inequities can be challenging given that multiple dietary components are low in quality. Mississippi Communities for Healthy Living was designed to test the comparative effectiveness of nutrition education using a single- versus multiple-message approach to improve the diet of adult residents in the Lower Mississippi Delta. Method. The single-message approach targeted discretionary calories while the multiple-message approach also targeted vegetables, fruits, whole grains, and lean protein. Delta food frequency questionnaires were used to measure participants’ diet, while the Healthy Eating Index–2005 (HEI-2005) was used to generate diet quality scores. Generalized linear mixed model regression was used to test for significant time, treatment, and time × treatment interaction effects in HEI-2005 component and total score changes. Results. The majority of participants in the single- and multiple-message arms ( n = 114 ...
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Sentinel lymph node biopsy is an established alternative to complete lymph node dissection in some patients. We have developed a novel, radiolabeled methylene blue dye that may be a useful alternative to the traditional two-step procedure... more
Sentinel lymph node biopsy is an established alternative to complete lymph node dissection in some patients. We have developed a novel, radiolabeled methylene blue dye that may be a useful alternative to the traditional two-step procedure involving 99mTc-labeled colloid and unlabeled blue dye. We hypothesize that 125I-labeled methylene blue will be rapidly absorbed into the lymphatics and transported to the drainage basin containing the sentinel nodes. Rabbits footpads were injected with 1 mCi of 125I-labeled methylene blue admixed with unlabeled dye. A hand-held gamma detection device allowed tracking of radiolabeled dye to nodes in the popliteal and inguinal regions. At pre-established time points animals were sacrificed, and the nodal basin dissected. Nodal radioactivity as well as uptake of blue dye was recorded. The spread of the radiolabeled methylene blue compound from the footpad to the popliteal lymph nodes occurred in 5-10 min. The radiolabeled dye rapidly progresses through lymphatics to the draining nodes. Use of radiolabeled methylene blue may be an attractive alternative to current two-step sentinel node techniques, as it may be less painful, and may reduce the cost associated with the time-delay between the injection of the radioactive compound and surgery.
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The study’s purpose was to collect demographic and farm characteristics from Mississippi small farmers and to determine their abilities, experiences, and desires to engage in Farm to School (F2S) activities. The online survey was created... more
The study’s purpose was to collect demographic and farm characteristics from Mississippi small farmers and to determine their abilities, experiences, and desires to engage in Farm to School (F2S) activities. The online survey was created using items taken from existing F2S surveys. Invitations to participate were sent via email to farmers beginning in October 2021 and ending in January 2022. Descriptive statistics were used to summarize the data. Of the 258 individuals with valid email addresses, 43 (17%) completed the online survey, and 38 fit the definition of small farm (
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Objectives The objectives of this study were to determine if interdependence relationships between sugar from sugar-sweetened beverage (SSB) intake and sugary drink liking existed in parent-adolescent dyads and if relationships were... more
Objectives The objectives of this study were to determine if interdependence relationships between sugar from sugar-sweetened beverage (SSB) intake and sugary drink liking existed in parent-adolescent dyads and if relationships were moderated by adolescent age and dyad sex. Methods Dyadic survey data from the cross-sectional, Internet-based Family Life, Activity, Sun, Health and Eating Study, conducted in 2014 were analyzed using actor-partner interdependence models. Parents and adolescents (12–17 years) completed demographic, diet and physical activity surveys. The outcome variable, dietary intake, was measured using a 27-item dietary screener. Explanatory variables included: (1) fruit drink liking and soda liking measured separately on 5-point Likert type scales for actor (self) and partner; (2) adolescent age in years; (3) parent-adolescent sex (male or female); and (4) 2-way interactions between explanatory variables. Results Interdependence effects were present for fruit drink ...
Research Interests: Psychology and Moderation
ABSTRACTIntroductionBehavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs... more
ABSTRACTIntroductionBehavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of intervention-covariate interactions. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups.Methods and analysisSystematic searches of Medline, Embase, CENTRAL, CINAHL, PsycInfo, and trial registries for all ongoing and completed randomised controlled trials evalua...
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Background: Physical activity levels were low for pregnant and postpartum participants in a diet and physical activity intervention. To explore micro level characteristics of participants’neighborhoods related to physical activity, an... more
Background: Physical activity levels were low for pregnant and postpartum participants in a diet and physical activity intervention. To explore micro level characteristics of participants’neighborhoods related to physical activity, an ancillary study was conducted. Methods: This cross-sectional study encompassed the neighborhood street segments of women participating in a diet and physical activity intervention that was conducted in the Lower Mississippi Delta. A neighborhood was defined as all street segments within one-fourth walking mile of a participant’s home address. Street segments were measured using the Rural Active Living Assessment’s Street Segment Assessment tool. In the field and on foot, raters measured street segments using neighborhood maps with segments identified. Results: Mean street segment length was 0.22 miles (SD = 0.14). All segments had flat terrain with residential (98%), open spaces (74%), and public/civic (34%) as the most prevalent land uses. Almost thre...
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Research Interests: Medicine and Hemoglobin
Little is known about the effective dose of motivational interviewing for maintaining intervention-induced health outcome improvements. The purpose of this study was to compare effects of two doses of motivational interviewing for... more
Little is known about the effective dose of motivational interviewing for maintaining intervention-induced health outcome improvements. The purpose of this study was to compare effects of two doses of motivational interviewing for maintaining blood pressure improvements in a community-engaged lifestyle intervention conducted with African-Americans. Participants were tracked through a 12-month maintenance phase following a 6-month intervention targeting physical activity and diet. For the maintenance phase, participants were randomized to receive a low (4) or high (10) dose of motivational interviewing delivered via telephone by trained research staff. Generalized linear models were used to test for group differences in blood pressure. Blood pressure significantly increased during the maintenance phase. No differences were apparent between randomized groups. Results suggest that 10 or fewer motivational interviewing calls over a 12-month period may be insufficient to maintain post-in...
Research Interests: Health Promotion, Nutrition, Health Education, Life Style, Life Sciences, and 15 moreDiet, Community, Medicine, Motivational Interviewing, Humans, African American, Blood Pressure, Female, Male, Exercise, African Americans, Middle Aged, Adult, Public health systems and services research, and Curriculum and Pedagogy
Intervention research in rural, health disparate communities presents unique challenges for study design, implementation, and evaluation. Challenges include 1) culturally appropriate intervention components, 2) participant recruitment and... more
Intervention research in rural, health disparate communities presents unique challenges for study design, implementation, and evaluation. Challenges include 1) culturally appropriate intervention components, 2) participant recruitment and retention, 3) treatment cross-contamination, 4) intervention delivery and data collection, and 5) potential measurement reactivity. The intent of Mississippi Communities for Healthy Living (MCHL) study was to test the effectiveness of an intervention promoting adoption of culturally relevant Dietary Guidelines for Americans components on diet quality. MCHL was developed using the RE-AIM planning and evaluation framework (reach, effectiveness, adoption, implementation, maintenance). Intervention components were based on Roger's diffusion of innovation attributes that promote adoption of a new innovation as well as on the psychosocial constructs of social support, self-efficacy and decisional balance. Participant outcomes included diet quality, b...
Research Interests: Health Promotion, Nutrition, Cultural Competency, Health Education, Life Sciences, and 15 moreDiet, Adolescent, Medicine, Humans, Blood Pressure, Female, Male, Mississippi, Behavior change, Data Collection, African Americans, Middle Aged, Adult, Nutrition Interventions, and Medical and Health Sciences
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Research Interests: Health Promotion, Life Style, Diet, Medicine, Linear models, and 15 moreCommunity Based Participatory Research, Motivational Interviewing, Cities, Humans, Hypertension, Female, Male, Mississippi, Body Mass Index, African Americans, Adult, European Continental Ancestry Group, Medicine and Health Sciences, Energy Intake, and Motor activity
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Objectives: In this study, we tested for moderation by neighborhood food outlet presence on relationships between food outlet shopping or meal sources and dietary intake. Methods: We used generalized linear models to analyze... more
Objectives: In this study, we tested for moderation by neighborhood food outlet presence on relationships between food outlet shopping or meal sources and dietary intake. Methods: We used generalized linear models to analyze parent-adolescent (12-17 years) dyad data from the 2014 Family Life, Activity, Sun, Health and Eating. Questions included food outlet presence in home (parent) and school (adolescent) neighborhoods (yes or no), shopping at food outlets (parent) (never, rarely, sometimes, often or always), and sources of food consumed away from and at home (weekly frequency). We captured food and beverage intakes via a dietary screener. Results: Relationships between adolescent added sugar intake and scratch cooked evening meals and meals away from home were found only when grocery stores and fast food restaurants, respectively, were present in adolescents' school neighborhoods. Shopping at fruit and vegetable (FV) markets and scratch cooked evening meals were associated with...
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ABSTRACTIntroductionLittle is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study... more
ABSTRACTIntroductionLittle is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and behaviour change techniques (BCTs), 2) explore similarities and differences in BCTs used to target behaviours, and 3) explore effectiveness of intervention components in preventing childhood obesity.Methods and analysisAnnual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the TOPCHILD Collaboration. Standard ontologies will be used to code targ...