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Biomedical subjects

A M Hartman

Publications and source records attributed to A M Hartman.

At least 37 records · Page 2Linked to original sources

Effects of alpha-tocopherol and beta-carotene supplements on cancer incidence in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study.

The Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study was a placebo-controlled, randomized intervention trial testing the hypothesis that beta-carotene and alpha-tocopherol (vitamin E) supplements prevent lung and other cancers. The study is predicated on a substantial body of evidence supporting a role in cancer prevention for these micronutrients. Based on the 2 x 2 factorial study design, 29,133 eligible male cigarette smokers aged 50-69 y were randomly assigned to receive beta-carotene (20 mg), alpha-tocopherol (50 mg), beta-carotene and alpha-tocopherol, or placebo daily for 5-8 y. Capsule compliance was high (median = 99%). beta-Carotene treatment did not result in a decrease in cancer at any of the major sites but rather in an increase at several sites, most notably lung, prostate, and stomach (number of cases 474 compared with 402, 138 compared with 112, and 70 compared with 56, respectively). The vitamin E group had fewer incident cancers of the prostate and colorectum compared with the group not receiving vitamin E (number of cases 99 compared with 151 and 68 compared with 81, respectively), but more cancers of the stomach (70 compared with 56). In contrast to these intervention-based findings for beta-carotene and vitamin E supplements, we observed lower lung cancer rates in men with higher amounts of both serum and dietary beta-carotene and vitamin E at baseline.

Aged↗

Smoking behavior, workplace policies, and public opinion regarding smoking restrictions in Maryland.

The Maryland Occupational Safety and Health (MOSH) advisory board recently proposed a smoking ban in most Maryland workplaces, including bars and restaurants, unless smoking is restricted to a separately ventilated area where nonsmoking workers cannot be required to enter. Results from the 1992-1993 Current Population Survey strongly suggest that there is broad support among Maryland residents for such restrictions and that the MOSH rules would merely extend an already widespread practice in the state. Efforts by the tobacco industry to gain an injunction against the proposed MOSH regulations would not appear to be supported by a clear majority of Maryland residents.

Adult↗

Revision of dietary analysis software for the Health Habits and History Questionnaire.

The software for analysis of the Health Habits and History Questionnaire (HHHQ) has been revised and is available to researchers. As in earlier versions of the software, questionnaires other than the standard National Cancer Institute versions can be analyzed. Foods can be added or dropped, nutrients can be added or changed, and many other revisions and options are facilitated. Estimates of 33 nutrients and up to 20 user-defined food groups are produced. The validity is unchanged from the previous software. Other features include a data entry key-and-verify system, standardized editing, a computer-assisted interview, and the calculation of health indices including pack-years of smoking and social network index.

Data Collection↗

Energy adjustment methods for nutritional epidemiology: the effect of categorization.

The authors discuss the interpretation of four alternative energy adjustment methods (Residual, Standard, Partition, and Nutrient Density) that have been proposed for the analysis of nutritional epidemiology studies. These methods have so far been compared under circumstances where intake of the nutrient of interest is measured as a continuous variable. Because it is common practice to categorize nutrient intakes in the analysis, the authors investigate the effect of such categorization on the interpretation of results from the four methods with the use of computer simulations and statistical theory. They consider four cases: where the nutrient intake is either divided into quartiles or ordered so as to investigate trend over the quartile groups, combined with using an adjusting variable that is either continuous or categorized. The results show: 1) the Residual, Standard, and Partition methods are no longer equivalent as they are in the continuous case; 2) compared with the Standard method, the Residual method appears to be more powerful for detecting trends in relative odds, is more robust to residual confounding when the adjustment variable is categorized, and provides more meaningful odds ratios; and 3) the Residual and Nutrient Density methods give closely similar results.

Bias↗

Contributions to the history of psychology: XCIX. Experimental study of infrahuman primate sexual behaviors: James Harlan Elder.

Prior to the 1930s, designs of research into sexual behavior of infrahuman primates were not comparable; conclusions about physiological and nonphysiological factors in receptivity and mating were confounded by species studied, living and testing conditions, and precaptivity history. Clearly there was need for comprehensive and controlled studies of infrahuman primate sexual behavior. In response to the controversy about biological bases of receptivity and mating, James Harlan Elder, in collaboration with Robert M. Yerkes, designed the first truly comprehensive study of factors influencing sexual behavior of chimpanzees. At that time, other persons interested in this problem were employing experimental methods, but Elder's and Yerkes' program most directly addressed the problems confounding prior study and their work served as a model of experimental research into factors affecting receptivity and mating of infrahuman primates.

Animals↗

Long-term therapy with low-dose isotretinoin for prevention of basal cell carcinoma: a multicenter clinical trial. Isotretinoin-Basal Cell Carcinoma Study Group.

BACKGROUND: High-dose isotretinoin has been reported to have a prophylactic effect on nonmelanoma skin cancer, although it is associated with significant toxicity. PURPOSE: To test the effectiveness of the long-term administration of low-dose isotretinoin in reducing the occurrence of basal cell carcinoma at a new site in patients with previously treated basal cell carcinomas and to measure the toxicity associated with this regimen, we conducted a clinical trial at eight cancer centers. METHODS: Nine hundred and eighty-one patients with two or more previously confirmed basal cell carcinomas were randomly assigned to receive either 10 mg of isotretinoin or a placebo daily. Patients were followed for 36 months and monitored at 6-month intervals for skin cancer and toxic effects. RESULTS: After 36 months of treatment, no statistically significant difference in either the cumulative percent of patients with an occurrence of basal cell carcinoma at a new site or the annual rate of basal cell carcinoma formation existed between patients receiving isotretinoin and those receiving the placebo. Elevated serum triglycerides, hyperostotic axial skeletal changes, and mucocutaneous reactions were more frequent in the group receiving isotretinoin than in the control group, and these differences were all statistically significant (P less than .001). CONCLUSION: This low-dose regimen of isotretinoin not only is ineffective in reducing the occurrence of basal cell carcinoma at new sites in patients with two or more previously treated basal cell carcinomas but also is associated with significant adverse systemic effects. IMPLICATION: The toxicity associated with the long-term administration of isotretinoin, even at the low dose used in this trial, must be weighted in planning future prevention trials.

Aged↗

Comparison of two dietary questionnaires validated against multiple dietary records collected during a 1-year period.

The validity of two dietary history questionnaires was examined, one the Health Habits and History Questionnaire (HHHQ) developed by Block et al and the other a questionnaire developed by investigators at the University of Michigan (UM). The reference data consisted of the mean of four 4-day dietary records and recalls collected for 1 year before administration of the questionnaires. The sample of 85 persons included black and white men and women aged 25 to 50 years. The HHHQ was entirely self-administered; the UM questionnaire had both self- and interviewer-administered components. The HHHQ group means were similar to food record estimates for energy and most nutrients, whereas the UM questionnaire produced overestimates for energy and all nutrients examined. Correlations ranged from .31 to .60 (median = .48) for the UM questionnaire and from .42 to .68 (median = .57) for the HHHQ. Use of respondent-reported portion sizes with the HHHQ produced higher correlations than use of investigator-determined "standard" portion sizes (median r = .43 vs .57). Food frequency questionnaires can provide useful nutrient data for individuals as well as groups.

Adult↗

Skeletal hyperostosis in patients receiving chronic, very-low-dose isotretinoin.

BACKGROUND AND DESIGN: We conducted a prospective roentgenographic survey of patients participating in a randomized, placebo-controlled, multicenter clinical trial that evaluated the effectiveness of chronic, very-low-dose (approximately 0.14 mg/kg per day for 3 years) isotretinoin in preventing the subsequent occurrences of new basal cell carcinoma in patients with previous basal cell carcinoma. To assess potential skeletal changes, a sample of 269 patients from among a total of 981 enrollees were randomly selected for comparative roentgenographic review. Baseline and 36-month roentgenograms of the cervical and thoracic spine of each patient were read side by side by a radiologist, masked to treatment group, who noted both the presence and extent of abnormalities at each vertebral level at baseline and the progression of existing or occurrence of new abnormalities at previously unaffected levels at 36 months. RESULTS: In comparison with the placebo group, significantly more patients in the isotretinoin group exhibited progression of existing hyperostotic abnormalities (40% vs 18%; P less than .001) and new hyperostotic involvement at previously unaffected vertebral levels (8% vs 1%; P = .015). CONCLUSION: Our findings indicate that chronic, very-low-dose isotretinoin can induce hyperostotic axial skeletal changes similar to those reported in patients taking higher doses.

Adult↗

Calibration of "pokes": psychophysical measurement of computer-generated temporal intervals.

To answer questions raised about the accuracy of temporal intervals used to produce perception of apparent motion, interstimulus intervals generated by a computer were measured using physical and psychophysical procedures. Calibration of such devices was assumed initially to be routine but search of the literature indicated that calibration has been ignored in studies of motion and masking. Direct/physical methods of calibration proved unfeasible for assessing the accuracy of a computer programmed through "poke" procedures because signals for temporal intervals could not be differentiated from the output controlled by the machine's "hardwired" program. The results of psychophysical measurement of temporal intervals indicated that, on the average, differences, "constant errors" between expected/programmed intervals and matches of those intervals generally were less than six milliseconds.

Adolescent↗

Variability in nutrient and food intakes among older middle-aged men. Implications for design of epidemiologic and validation studies using food recording.

The authors conducted a dietary methodology study in 1984 in Finnish men aged 55-69 years in order to validate two dietary assessment instruments being used in the US-Finland Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention Trial. Twelve 2-day food records collected from 162 men over a 6-month period, including every day of the week, served as the reference measure. This report focuses on three important questions for investigating diet and disease relations: 1) How many days are necessary to classify "usual" intake? 2) Is there loss as a result of using consecutive days? 3) Which days are necessary for assessment and classification of "usual" diet? A repeated-measures regression model was used to estimate the variance components and the effects of consecutive days, weekday (weekday vs. weekend), and season. Correlations between the averages of different numbers of days of food records and "true" usual intake were examined along with the resulting attenuations in relative risk. Results suggest that 7-14 days are required to adequately classify most individuals into categories of intake for most nutrients and some foods. There appears to be some loss of information from using consecutive days rather than days further apart. Weekday/weekend differences in mean intakes are slight, and the rank ordering of individuals appears to be preserved. A moderate seasonal effect is shown for classification of fruits, but only a slight one is seen for micronutrients and berries. Implications for the design of epidemiologic and validation studies are discussed.

Aged↗

A reduced dietary questionnaire: development and validation.

A reduced questionnaire was developed by successively omitting segments of the full (98-item) Block questionnaire and calculating the correlations between nutrient estimates produced by the full and reduced versions. The reduced version contains 60 food items and requires 17 minutes to administer by an interviewer. It is intended to capture all nutrients in the diet, as is the full version. The reduced version was validated against three four-day records in a group of middle-aged women, and against two seven-day records collected 10-15 years ago in a group of older men. The absolute value of macronutrients estimated by the reduced questionnaire was lower than food-record estimates, but most micronutrients were not underestimated. For macronutrients correlations with food records were slightly lower with the reduced questionnaire, but for micronutrients there was only slight or no reduction in correlations as a result of using the reduced version. The brief version may be useful in studies that cannot allow the 30-35 minutes required for the full-length questionnaire.

Aged↗

The apparent validity of diet questionnaires is influenced by number of diet-record days used for comparison.

The effect of the number of diet records used as the reference data on the apparent validity of a diet history questionnaire was examined using data from 97 participants in the Women's Health Trial feasibility study. Pearson correlation coefficients were computed between the estimates of usual individual intake from the questionnaire and estimates from the mean of three 4-day records obtained over a 1-year period, the mean of the two most recent records, and the record obtained 1 year after the start of the study. The results illustrate that the apparent validity of a questionnaire increases when it is compared with a greater number of 4-day food records. The correlations increased for most nutrients when the baseline food record was included, despite the fact that it was completed at a time not targeted by the questionnaire. These findings suggest that greater effort should be given to obtaining more diet-record days when validating other dietary assessment instruments.

Aged↗

Issues in reproducibility and validity of dietary studies.

Numerous factors affect the reproducibility and validity of dietary assessment questionnaires. Although the respondents' abilities to respond accurately are most frequently discussed as the cause of apparently poor reproducibility and validity, many other factors are as important and perhaps more important. Most of these other factors are under the control of the investigator, and thus are amenable to improvement. Factors which may affect reproducibility included the degree of variability permitted by the instrument, the error-proneness of the response format, quality control of coding and keying and real dietary change in the time between the two administrations of the questionnaire. Factors affecting real or apparent validity include respondent characteristics, questionnaire design and quantification, quality control, and the adequacy of the reference data. The implications of inadequate reference data are illustrated and discussed.

Humans↗

Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet.

A self-administered food use questionnaire which included 276 food items and mixed dishes and a portion size picture booklet with 122 photographs was developed for a large lung cancer intervention trial among approximately 27,000 Finnish men aged 50-69 years. The reproducibility and validity of this questionnaire were studied from March to October 1984. In the reproducibility study, 121 men aged 55-69 years completed the questionnaire three times, at three-month intervals. The intraclass correlations varied from 0.56 for vitamin A to 0.88 for alcohol, with most falling between 0.60 and 0.70. In the validity study, 190 men of similar age kept food consumption records for 12 two-day periods, distributed evenly over a period of six months, and filled in the questionnaire both before and after this period. Correlations between nutrient intake values from the food records and the food use questionnaires ranged from 0.40 for selenium to 0.80 for alcohol. Among subjects who belonged to the lowest quintile on the basis of the food record measurement, an average of 51 per cent fell into the same quintile and 76 per cent fell into the lowest two quintiles when they were categorized on the basis of the food use questionnaire. Findings were similar for the upper tail of the distribution. These data indicate that the self-administered food use questionnaire is useful for measuring individual or group intakes for a variety of nutrients.

Aged↗

Reproducibility and validity of dietary assessment instruments. II. A qualitative food frequency questionnaire.

The reproducibility and validity of a food frequency questionnaire designed to measure intakes of total fat, saturated and polyunsaturated fats, vitamins A, C, and E, selenium, and dietary fiber were tested from March to October 1984 among 297 Finnish men aged 55-69 years. The questionnaire asked about consumption of 44 food items. In the reproducibility study, 107 subjects filled in the questionnaire three times, at three-month intervals. Intraclass correlations varied from 0.52 for vitamin A to 0.85 for polyunsaturated fat. In the validity study, 190 subjects kept food consumption records for 12 two-day periods distributed evenly over a period of six months and filled in the questionnaire both before and after this period. Correlations between the nutrient intake values from the food records and those from the food frequency questionnaires ranged from 0.33 for selenium to 0.68 for polyunsaturated fat. On the average, 40-45% of the subjects in the lowest and highest quintiles based on food records were in the same respective quintiles when assessed by the food frequency questionnaire, and 70-75% were in the two lowest and two highest questionnaire quintiles, respectively. The food frequency questionnaire and a quantitative food use questionnaire tested in the same study were compared. Use of these two instruments in large-scale epidemiologic studies is discussed.

Ascorbic Acid↗

A data-based approach to diet questionnaire design and testing.

A self-administered diet history questionnaire has been developed for epidemiologic and clinical use. Both the food list and the nutrient values to be associated with it were developed using dietary data from 11,658 adult respondents to the Second National Health and Nutrition Examination Survey (NHANES II). Food items were selected on the basis of their contribution to total population intake of energy and each of 17 nutrients in the NHANES II data, and represent over 90% of each of those nutrients. Associated nutrient composition values were determined from the NHANES II database using frequency of consumption data in that survey. Portion sizes to be associated with each food item were derived from observed portion size distributions in NHANES II, based on three-dimensional models. The resulting food list and its corresponding brief data base, when used to calculate nutrients from a diet record, yielded correlations of r greater than 0.70 with the more detailed method. Field administration produced mean values comparable to national data.

Adult↗

Indicator foods for vitamin A assessment.

Epidemiological interview studies examining the association between vitamin A and cancer at various sites have been hampered by restricted time available for interview; consequently, studies have included varying lists of food items or broad food groups, thus making comparability of results difficult. To identify a standardized list of indicator foods that adequately assess total vitamin A intake, we examined the 24-hour dietary recall of 13,201 adults who participated in the First National Health and Nutrition Examination Survey (NHANES I) from 1971 to 1974. Food items reportedly consumed were ranked by contribution to overall (aggregated) intake in various subpopulations by an index of vitamin A contribution, which reflected the frequency of consumption, portion size, and vitamin A concentration (IUs/100 g). A comparison of these ranks identified certain food items that had a relative contribution to vitamin A intake which varied by sex/race group, season of interview, age, or region of the country; income level had little effect on the food rankings. The top-ranking 50 foods were sufficient to correctly classify 80%-90% of the individuals into low-, moderate-, and high-consumer categories. The major contributing foods for any subpopulation examined included both retinol (e.g., dairy products, liver) and carotenoid sources of vitamin A (e.g., certain fruits and vegetables) in addition to items (e.g., mixed tomato and cheese dishes) not included in earlier questionnaire studies. Recommendations are made for future questionnaires designed to assess vitamin A.

Adolescent↗