Preconception health status and associated disparities among rural, Midwestern women in the United States.

Background: Little is known about the preconception/interconception health and behaviors of reproductive-age women in the rural Midwest of the United States. The purpose of this study was to quantify preconception/interconception health status and to identify disparities compared with statewide estimates.

Methods: In this cross-sectional study, we collected data on 12 health conditions and behaviors that are risk factors for adverse maternal and infant health outcomes from nonpregnant women ages 18-45 years in rural northwestern Ohio.

Routine Healthcare Utilization Among Reproductive-Age Women Residing in a Rural Maternity Care Desert.

It is important that women of reproductive age have access to and use routine health services to improve birth outcomes. While it is estimated that more than 5 million women in over 1000 counties across the United States live in maternity care deserts, to date there have been no published studies characterizing access and barriers to routine healthcare utilization in these areas. Therefore, a cross-sectional study was conducted in a rural county in northwest Ohio with 315 women ages 18-45 years.

Barriers to Weight Management Among Overweight and Obese Firefighters.

Objective: To examine barriers to weight management among firefighters.

Methods: Health risk data collected on 2373 overweight firefighters were used for this cross-sectional study. Barriers to weight management were the dependent variables and demographic characteristics, readiness for change, and health risk factors were the correlates in the multivariate-adjusted logistic models.

Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men.

Importance: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Robust evidence indicates an association of increased physical fitness with a lower risk of CVD events and improved longevity; however, few have studied simple, low-cost measures of functional status.

Objective: To evaluate the association between push-up capacity and subsequent CVD event incidence in a cohort of active adult men.

Excess mortality among Indiana firefighters, 1985-2013.

Background: Firefighters are exposed to toxic agents increasing their risk for cancer and cardiovascular disease. We examined the odds of cancer and cardiovascular mortality of firefighters relative to a matched group of non-firefighters from the general population.

Methods: Firefighter death records were matched to four non-firefighter death records on age at time of death, sex, race, ethnicity, and year of death.

Associations of metabolic syndrome and C-reactive protein with mortality from total cancer, obesity-linked cancers and breast cancer among women in NHANES III.

Although metabolic syndrome (MetS) is a prognostic factor for cancer occurrence, the association of MetS and cancer mortality remains unclear. The purpose of this study was to evaluate whether MetS, components of MetS and C-reactive protein (CRP) are associated with cancer mortality in women. A total of 400 cancer deaths, with 140 deaths from obesity-linked-cancers (OLCas), [breast (BCa), colorectal, pancreatic and endometrial], linked through the National Death Index, were identified from 10,104 eligible subjects aged ≥18 years.

Assessment of risk behaviors in patients with opioid prescriptions: A study of indiana's inspect data.

Background And Objectives: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients' likelihood to engage in opioid-related risk behaviors.

Methods: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines.

Dietary intake of isoflavones and coumestrol and the risk of prostate cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

Experimental studies have revealed that phytoestrogens may modulate the risk of certain sites of cancer due to their structural similarity to 17β-estradiol. The present study investigates whether intake of these compounds may influence prostate cancer risk in human populations. During a median follow up of 11.

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia.

Background: Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear.

Aims: To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor.

Association between Urinary Phytoestrogens and C-reactive Protein in the Continuous National Health and Nutrition Examination Survey.

Objective: A reduced risk of some cancers and cardiovascular disease associated with phytoestrogen intake may be mediated through its effect on serum C-reactive protein (CRP; an inflammation biomarker). Therefore, this study examined the associations between urinary phytoestrogens and serum CRP.

Methods: Urinary phytoestrogen and serum CRP data obtained from 6009 participants aged ≥ 40 years in the continuous National Health and Nutrition Examination Survey during 1999-2010 were analyzed.

Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses.

Among the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21-35 attending a local minority health fair in July 2015.

A Community Needs Assessment of the Physical Activity and Food Environment in a Predominantly Hispanic U.S. City.

Introduction: Hispanics suffer disproportionately compared with non-Hispanic Whites from health conditions that are affected by physical inactivity and poor dietary habits.

Method: A needs assessment was conducted in Hialeah, Florida, the largest enclave of Cubans in the United States, to assess the perspectives of community stakeholders and members regarding the roles of physical activity and nutrition environments. Interviews were performed with community stakeholders (n = 21), and responses were grouped into major themes.

Adult BMI change and risk of Breast Cancer: National Health and Nutrition Examination Survey (NHANES) 2005-2010.

Objective: Breast cancer is the second leading cause of cancer mortality among women in the developed world. This study assessed the association between occurrence of breast cancer and body mass index (BMI) change from age 25 to age closest to breast cancer diagnosis while exploring the modifying effects of demographic variables.

Methods: The National Health and Nutrition Examination Survey data were used.

Urinary phytoestrogens and cancer, cardiovascular, and all-cause mortality in the continuous National Health and Nutrition Examination Survey.

Purpose: Experimental studies suggest that phytoestrogen intake alters cancer and cardiovascular risk. This study investigated the associations of urinary phytoestrogens with total cancer (n = 79), cardiovascular (n = 108), and all-cause (n = 290) mortality among 5179 participants in the continuous National Health and Nutrition Examination Survey (1999-2004).

Methods: Urinary phytoestrogens were measured using high-performance liquid chromatography with tandem mass spectrometric detection.

Trends in patient encounters: implications for family medicine clerkships.

Background And Objectives: Adequate and equivalent clinical experience is related to the number and diagnoses of patients encountered and should provide students with experiences similar to community practice. This study compares the distribution of diagnoses family medicine clerkship students encountered at a Midwest medical school during 2009-2011 with both 1997-1999 data and the 2010 National Ambulatory Medical Care Survey (NAMCS) samples of family physicians and all physicians.

Methods: Electronically submitted encounter data (2009-2011) were compared to logbook data (1997-1999) and to the 2010 NAMCS data listing primary diagnoses at office visits in the United States by major disease category.

A model for estimating the economic impact of secondhand smoke exposure: a study in Indiana.

Objective: This study estimated the economic cost of health services and premature loss-of-life costs from secondhand smoke (SHS) exposure in Indiana.

Design And Setting: Costs of SHS-related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to SHS exposure both for adults and children. Estimated direct costs included hospital inpatient costs, loss-of-life costs, and ambulatory care costs where available, based on the most currently available Indiana hospital discharge data, vital statistics, census data, and nationally published research.

Effect of personal characteristics on individual support for indoor smoke-free air laws, Indiana, 2008.

Introduction: Policy makers should understand the attitudes and beliefs of their constituents regarding smoke-free air legislation. The purpose of this study was to evaluate the effect of selected personal characteristics on attitudes and beliefs about secondhand smoke in Indiana and on support for smoke-free air laws.

Methods: Data were obtained from the 2008 Indiana Adult Tobacco Survey of 2,140 adults and included 11 sociodemographic variables.

Surgical staging of endometrial cancer: robotic versus open technique outcomes in a contemporary single surgeon series.

Patients prefer robotic surgery due to perceived cosmetic advantages and quicker resumption of regular activity. We compared the results of hysterectomy and surgical staging for endometrial cancer using robotic versus open techniques in patients operated on by a single surgeon. A retrospective clinical data analysis was performed of all patients who underwent surgical staging for endometrial cancer.

Dietary behaviors associated with fruit and vegetable consumption, Marion County, Indiana, 2005.

Introduction: Eating inadequate amounts of fruits and vegetables is associated with diminished health, and most Americans fall short of the Centers for Disease Control and Prevention's recommendation to eat at least 2 servings of fruit and 3 servings of vegetables each day. This study assessed behaviors associated with fruit and vegetable consumption in adults.

Methods: A cross-sectional, random-digit-dialed telephone survey of 4,784 adults living in Marion County (Indianapolis), Indiana, measured demographic characteristics, personal health data, food consumption, food label use, and other eating habits.

The effect of pregnancy intention on important maternal behaviors and satisfaction with care in a socially and economically at-risk population.

This study examined the association of pregnancy intention with maternal behaviors and the woman's perceived satisfaction with her prenatal and delivery care. Face-to-face interviews with 478 primarily Medicaid eligible women in Indianapolis, Indiana during their postpartum hospital stay were conducted to assess their degree of satisfaction with prenatal care and pregnancy intention, stratified into wanting to be pregnant now, later or never. Behaviors and characteristics influencing utilization of prenatal care were obtained from linked birth certificate data.

Effects of personal characteristics on African-American women's beliefs about breast cancer.

Purpose: This study measured the effect of demographic and clinical characteristics on health and cultural beliefs related to mammography.

Design: Cross-sectional study.

Setting: Interviews were conducted during 2003 and 2004 in a Midwestern urban area.

Trends in adult attitudes toward secondhand smoke in Indiana, 2002-2007: the impact of smoking status.

Purpose: As more research has been distributed through the media about the negative health impact of exposure to secondhand smoke (SHS), the public's support for smoke-free policies has increased. The purpose of this study was to evaluate trends in knowledge and attitudes about SHS exposure among Indiana adults by smoking status.

Methods: Study data were from four cross-sectional studies previously conducted by the Indiana Tobacco Prevention and Cessation Agency using the Adult Tobacco Survey protocol between the years 2002 and 2007.

Risk of mesh erosion after abdominal sacral colpoperineopexy with concomitant hysterectomy.

Objective: The purpose of this study was to evaluate the effect of concomitant hysterectomy at the time of abdominal sacral colpoperineopexy on the risk of mesh erosion with the use of type 1 polypropylene mesh.

Study Design: This was a retrospective case control study. All cases of vaginal mesh erosion (n = 31) were compared with matched control cases (n = 93) in a 3:1 ratio.

The influence of regional basic science campuses on medical students' choice of specialty and practice location: a historical cohort study.

Background: Indiana University School of Medicine (IUSM) employs eight regional basic science campuses, where half of the students complete their first two years of medical school. The other half complete all four years at the main campus in Indianapolis. The authors tested the hypothesis that training at regional campuses influences IUSM students to pursue primary care careers near the regional campuses they attended.