Lora Fleming - Academia.edu (original) (raw)
Papers by Lora Fleming
Figure S1. Time series plots of meteorological variables. (PNG 314 kb)
Environmental health : a global access science source, Jan 5, 2017
The impacts of climate on health and wellbeing occur in time and space and through a range of ind... more The impacts of climate on health and wellbeing occur in time and space and through a range of indirect, complicated mechanisms. This diversity of pathways has major implications for national public health planning and influence on interventions that might help to mitigate and adapt to rapidly changing environmental conditions, nationally and internationally. This paper draws upon evidence from public health and adverse impact studies across climate science, hydrology, agriculture, public health, and the social sciences. It presents a conceptual model to support decision-making by recognizing both the proximal and distal pathways from climate-induced environmental change to national health and wellbeing. The proximal and distal pathways associated with food security, migration and mobility illustrate the diverse climate change influences in different geographic locations over different timescales. We argue that greater realization and articulation of proximal and distal pathways shou...
ABSTRACT Title: Impacts of Work and Work Characteristics on Smoking Behavior among Adolescents an... more ABSTRACT Title: Impacts of Work and Work Characteristics on Smoking Behavior among Adolescents and Younger Adults OBJECTIVE: Examine the effects of work and work characteristics on smoking behaviors (current casual smoking and current frequent smoking) among adolescents (11-17) and younger adults (18-34) separately. METHODS: Four time points of the National Longitudinal Study of Adolescent Health were analyzed in logistic regression models using over 40,000 pooled person-by-time observations. Models evaluate whether having a job, hours worked, age at first job, and type of first job affect smoking differentially during adolescence and early adulthood after controlling for basic demographics and smoking predictors. RESULTS: Among adolescents, having a job does not increase the odds of smoking or frequent smoking; alternatively, having a job decreases the odds of smoking and frequent smoking for adults by 55%. However, having a job during adolescence increases the odds of smoking into adulthood (OR=1.20 [1.04, 1.37]). Furthermore, ten additional hours of work per week increases the odds of smoking and frequent smoking for both adolescents (8% and 12%, respectively) and adults (34% and 28%, respectively). First-time jobs in food service increase the odds of smoking by 18% for adolescents and 20% for adults. Starting a first job one year older decreases the odds of current smoking during adolescence (OR=0.95 [0.91, 0.99]) and in early adulthood (OR=0.92 [0.88, 0.95]). CONCLUSION: Working and the nature of work during adolescence including the amount and type of work and the age at first job have lasting effects on smoking behaviors into early adulthood.
ABSTRACT Introduction: We sought to identify high-risk areas of pancreatic cancer incidence and d... more ABSTRACT Introduction: We sought to identify high-risk areas of pancreatic cancer incidence and determine if PC clusters were more likely to be located near arsenic-contaminated drinking water wells. Methods: Spatial modeling was applied to pancreatic cancer cases diagnosed between 1998-2002 in Florida (n=11,405). Multivariable regression was used to determine if sociodemographic indicators, smoking history, and proximity to arsenic-contaminated well sites were associated with residence at the time of pancreatic cancer diagnosis within versus outside a cluster. Results: Spatial modeling identified 2581 clusters in which 24.8% of all pancreatic cancer cases were located. Cases living within 4 miles and 1 mile of known arsenic-contaminated wells were significantly more likely to be diagnosed within a cluster of pancreatic cancers relative to cases living more than 4 miles from known sites (Odds Ratio= 1.58 [95% confidence interval=1.38-1.81] and 2.0 [1.59-2.52], respectively). Conclusions: Exposure to arsenic-contaminated wells may be associated with an increased risk of pancreatic cancer. Case-control studies are needed in order to confirm the findings of this ecological analysis.
Preventing chronic disease, 2011
Smoking is a modifiable risk factor for age-related macular degeneration (AMD), the leading cause... more Smoking is a modifiable risk factor for age-related macular degeneration (AMD), the leading cause of irreversible vision loss in the United States. We conducted a pilot study among eye care providers and AMD patients to assess smoking cessation preferences and cessation services offered at a large academic medical center. Most patients who smoke reported never being advised to quit smoking, although most eye care providers reported that they had advised smokers to quit. Two-thirds of providers expressed a desire for additional training and resources to support patient quit attempts, indicating the need for the integration of smoking cessation opportunities in the clinic setting.
Journal of registry management, 2009
The study of cancer in Hispanics in the United States has been hindered by misclassification of H... more The study of cancer in Hispanics in the United States has been hindered by misclassification of Hispanics as non-Hispanic and by the convenient practice of aggregating the diverse Hispanic subgroups into a general Hispanic category. The Hispanic Origin Identification Algorithm (HOIA) was developed to improve the identification of both the general Hispanic ethnicity and the specific Hispanic subgroup in cancer incidence data. Using an independent study of prostate cancer cases from South Florida as the "gold standard" and the Florida incident cancer registry data, we validated this algorithm and studied the characteristics of those Hispanics whose ethnicity was commonly missed in the cancer registry records. Overall,…
Cancer Epidemiology Biomarkers & Prevention, 2009
American Journal of Public Health, 2009
Aerosol and Air Quality Research, 2012
Ambio, Jan 21, 2015
The use of molecular tools, principally qPCR, versus traditional culture-based methods for quanti... more The use of molecular tools, principally qPCR, versus traditional culture-based methods for quantifying microbial parameters (e.g., Fecal Indicator Organisms) in bathing waters generates considerable ongoing debate at the science-policy interface. Advances in science have allowed the development and application of molecular biological methods for rapid (~2 h) quantification of microbial pollution in bathing and recreational waters. In contrast, culture-based methods can take between 18 and 96 h for sample processing. Thus, molecular tools offer an opportunity to provide a more meaningful statement of microbial risk to water-users by providing near-real-time information enabling potentially more informed decision-making with regard to water-based activities. However, complementary studies concerning the potential costs and benefits of adopting rapid methods as a regulatory tool are in short supply. We report on findings from an international Working Group that examined the breadth of ...
Figure S5 shows: a) Average weekly reported Campylobacter cases averaged over 20 years (from 1989... more Figure S5 shows: a) Average weekly reported Campylobacter cases averaged over 20 years (from 1989 to 2009). All time series were square root transformed and then normalised to sum to unity. c) wavelet power spectrum of the transformed time-series of Campylobacter. Low values of the power spectrum are shown in dark blue, and high values in dark red. The black lines show the maxima of the undulations of the wavelet power spectrum. The light white shaded areas identify the region subjected to errors arising from dealing with a finite-length time series (edge effect). e) global average wavelet power spectrum, the black dots show the 5% significant levels computed based on 100 bootstrapped series g) original and reconstructed time-series according to all harmonics and the selected first 3 harmonics only. b), d), f) h) As in figures a), c) e) and g) but after the time-series of Campylobacter cases were adjusted using a seven day rolling mean, removal of bank holiday artefacts and adjusted...
Table S2. Mean cross correlations for weather Groups. (CSV 346 bytes)
Harmful Algal Blooms (HABs) occur throughout the world with Florida having the distinction of bei... more Harmful Algal Blooms (HABs) occur throughout the world with Florida having the distinction of being home to all major toxin-producing marine, estuarine and freshwater microalgae. The subtropical warm climate, 1200 miles of coastline, varied aquatic habitats and the human interface through seafood consumption and from water activities compose an environment where the presence of aquatic toxins can have a significant impact on public health. In Florida, the estimated annual economic impacts from HABs are in the magnitude of millions of dollars with direct effects to both tourism and public health. Nationwide, approximately $22 million is attributable to public health issues related to seafood ingestion alone (Anderson et al., 2000). Additional costs yet to be determined relate to respiratory illness, lost wages due to illness and increased burden on the health care. During the past two decades there has been a dramatic increase in the population along Florida’s coastline; 80% of the p...
ISEE Conference Abstracts
The talk at the Environment and Health conference generated a lot of feedback and interest in the... more The talk at the Environment and Health conference generated a lot of feedback and interest in the topic, particularly because of the identified interconnections between environment and human health in our conceptual model, which was a key topic of this event. By addressing inefficiencies introduced by discipline and policy barriers and through linking environmental health and ecosystem services in order to foster mutual understanding and improvements�to human health and well-being, the talk appealed to a wide range of scientific disciplines and has fostered early stage collaborations with social scientists and health experts. A follow-up talk has been presented at the LWEC Conference in 2013 (by George Morris) and a high level paper is in preparation.
ISEE Conference Abstracts
Introduction A high proportion of the UK population has been reported as allergic to pollen. Thes... more Introduction A high proportion of the UK population has been reported as allergic to pollen. These have increased in prevalence in the UK population quickly over the last 20 years. Pollen from tree...
Ethnicity & disease, 2010
Community Health Centers (CHCs) are the nation's primary care safety net for vulnerable popul... more Community Health Centers (CHCs) are the nation's primary care safety net for vulnerable populations, including racial/ethnic minorities, immigrants, migrant workers, and those who are uninsured. Women from such population sub-groups contribute disproportionately to cervical cancer incidence, morbidity, and mortality due, in large part, to the underutilization of Papanicolau (Pap) smear screening. Routine Pap smear screening can detect the onset and prevent progression of cervical malignancies. This article reports findings of a cross-sectional study to investigate the association between Pap smear compliance and patient race/ethnicity, insurance, and age for more than 60,000 women seen in a network of CHCs in Florida. Results of this study indicated a strong association between race/ ethnicity and Pap smear screening in CHCs. Among women aged 21-45 years, Hispanics were twice as likely to receive Pap smear screening, while Blacks were 1.45 times more likely to receive Pap smear ...
Figure S1. Time series plots of meteorological variables. (PNG 314 kb)
Environmental health : a global access science source, Jan 5, 2017
The impacts of climate on health and wellbeing occur in time and space and through a range of ind... more The impacts of climate on health and wellbeing occur in time and space and through a range of indirect, complicated mechanisms. This diversity of pathways has major implications for national public health planning and influence on interventions that might help to mitigate and adapt to rapidly changing environmental conditions, nationally and internationally. This paper draws upon evidence from public health and adverse impact studies across climate science, hydrology, agriculture, public health, and the social sciences. It presents a conceptual model to support decision-making by recognizing both the proximal and distal pathways from climate-induced environmental change to national health and wellbeing. The proximal and distal pathways associated with food security, migration and mobility illustrate the diverse climate change influences in different geographic locations over different timescales. We argue that greater realization and articulation of proximal and distal pathways shou...
ABSTRACT Title: Impacts of Work and Work Characteristics on Smoking Behavior among Adolescents an... more ABSTRACT Title: Impacts of Work and Work Characteristics on Smoking Behavior among Adolescents and Younger Adults OBJECTIVE: Examine the effects of work and work characteristics on smoking behaviors (current casual smoking and current frequent smoking) among adolescents (11-17) and younger adults (18-34) separately. METHODS: Four time points of the National Longitudinal Study of Adolescent Health were analyzed in logistic regression models using over 40,000 pooled person-by-time observations. Models evaluate whether having a job, hours worked, age at first job, and type of first job affect smoking differentially during adolescence and early adulthood after controlling for basic demographics and smoking predictors. RESULTS: Among adolescents, having a job does not increase the odds of smoking or frequent smoking; alternatively, having a job decreases the odds of smoking and frequent smoking for adults by 55%. However, having a job during adolescence increases the odds of smoking into adulthood (OR=1.20 [1.04, 1.37]). Furthermore, ten additional hours of work per week increases the odds of smoking and frequent smoking for both adolescents (8% and 12%, respectively) and adults (34% and 28%, respectively). First-time jobs in food service increase the odds of smoking by 18% for adolescents and 20% for adults. Starting a first job one year older decreases the odds of current smoking during adolescence (OR=0.95 [0.91, 0.99]) and in early adulthood (OR=0.92 [0.88, 0.95]). CONCLUSION: Working and the nature of work during adolescence including the amount and type of work and the age at first job have lasting effects on smoking behaviors into early adulthood.
ABSTRACT Introduction: We sought to identify high-risk areas of pancreatic cancer incidence and d... more ABSTRACT Introduction: We sought to identify high-risk areas of pancreatic cancer incidence and determine if PC clusters were more likely to be located near arsenic-contaminated drinking water wells. Methods: Spatial modeling was applied to pancreatic cancer cases diagnosed between 1998-2002 in Florida (n=11,405). Multivariable regression was used to determine if sociodemographic indicators, smoking history, and proximity to arsenic-contaminated well sites were associated with residence at the time of pancreatic cancer diagnosis within versus outside a cluster. Results: Spatial modeling identified 2581 clusters in which 24.8% of all pancreatic cancer cases were located. Cases living within 4 miles and 1 mile of known arsenic-contaminated wells were significantly more likely to be diagnosed within a cluster of pancreatic cancers relative to cases living more than 4 miles from known sites (Odds Ratio= 1.58 [95% confidence interval=1.38-1.81] and 2.0 [1.59-2.52], respectively). Conclusions: Exposure to arsenic-contaminated wells may be associated with an increased risk of pancreatic cancer. Case-control studies are needed in order to confirm the findings of this ecological analysis.
Preventing chronic disease, 2011
Smoking is a modifiable risk factor for age-related macular degeneration (AMD), the leading cause... more Smoking is a modifiable risk factor for age-related macular degeneration (AMD), the leading cause of irreversible vision loss in the United States. We conducted a pilot study among eye care providers and AMD patients to assess smoking cessation preferences and cessation services offered at a large academic medical center. Most patients who smoke reported never being advised to quit smoking, although most eye care providers reported that they had advised smokers to quit. Two-thirds of providers expressed a desire for additional training and resources to support patient quit attempts, indicating the need for the integration of smoking cessation opportunities in the clinic setting.
Journal of registry management, 2009
The study of cancer in Hispanics in the United States has been hindered by misclassification of H... more The study of cancer in Hispanics in the United States has been hindered by misclassification of Hispanics as non-Hispanic and by the convenient practice of aggregating the diverse Hispanic subgroups into a general Hispanic category. The Hispanic Origin Identification Algorithm (HOIA) was developed to improve the identification of both the general Hispanic ethnicity and the specific Hispanic subgroup in cancer incidence data. Using an independent study of prostate cancer cases from South Florida as the "gold standard" and the Florida incident cancer registry data, we validated this algorithm and studied the characteristics of those Hispanics whose ethnicity was commonly missed in the cancer registry records. Overall,…
Cancer Epidemiology Biomarkers & Prevention, 2009
American Journal of Public Health, 2009
Aerosol and Air Quality Research, 2012
Ambio, Jan 21, 2015
The use of molecular tools, principally qPCR, versus traditional culture-based methods for quanti... more The use of molecular tools, principally qPCR, versus traditional culture-based methods for quantifying microbial parameters (e.g., Fecal Indicator Organisms) in bathing waters generates considerable ongoing debate at the science-policy interface. Advances in science have allowed the development and application of molecular biological methods for rapid (~2 h) quantification of microbial pollution in bathing and recreational waters. In contrast, culture-based methods can take between 18 and 96 h for sample processing. Thus, molecular tools offer an opportunity to provide a more meaningful statement of microbial risk to water-users by providing near-real-time information enabling potentially more informed decision-making with regard to water-based activities. However, complementary studies concerning the potential costs and benefits of adopting rapid methods as a regulatory tool are in short supply. We report on findings from an international Working Group that examined the breadth of ...
Figure S5 shows: a) Average weekly reported Campylobacter cases averaged over 20 years (from 1989... more Figure S5 shows: a) Average weekly reported Campylobacter cases averaged over 20 years (from 1989 to 2009). All time series were square root transformed and then normalised to sum to unity. c) wavelet power spectrum of the transformed time-series of Campylobacter. Low values of the power spectrum are shown in dark blue, and high values in dark red. The black lines show the maxima of the undulations of the wavelet power spectrum. The light white shaded areas identify the region subjected to errors arising from dealing with a finite-length time series (edge effect). e) global average wavelet power spectrum, the black dots show the 5% significant levels computed based on 100 bootstrapped series g) original and reconstructed time-series according to all harmonics and the selected first 3 harmonics only. b), d), f) h) As in figures a), c) e) and g) but after the time-series of Campylobacter cases were adjusted using a seven day rolling mean, removal of bank holiday artefacts and adjusted...
Table S2. Mean cross correlations for weather Groups. (CSV 346 bytes)
Harmful Algal Blooms (HABs) occur throughout the world with Florida having the distinction of bei... more Harmful Algal Blooms (HABs) occur throughout the world with Florida having the distinction of being home to all major toxin-producing marine, estuarine and freshwater microalgae. The subtropical warm climate, 1200 miles of coastline, varied aquatic habitats and the human interface through seafood consumption and from water activities compose an environment where the presence of aquatic toxins can have a significant impact on public health. In Florida, the estimated annual economic impacts from HABs are in the magnitude of millions of dollars with direct effects to both tourism and public health. Nationwide, approximately $22 million is attributable to public health issues related to seafood ingestion alone (Anderson et al., 2000). Additional costs yet to be determined relate to respiratory illness, lost wages due to illness and increased burden on the health care. During the past two decades there has been a dramatic increase in the population along Florida’s coastline; 80% of the p...
ISEE Conference Abstracts
The talk at the Environment and Health conference generated a lot of feedback and interest in the... more The talk at the Environment and Health conference generated a lot of feedback and interest in the topic, particularly because of the identified interconnections between environment and human health in our conceptual model, which was a key topic of this event. By addressing inefficiencies introduced by discipline and policy barriers and through linking environmental health and ecosystem services in order to foster mutual understanding and improvements�to human health and well-being, the talk appealed to a wide range of scientific disciplines and has fostered early stage collaborations with social scientists and health experts. A follow-up talk has been presented at the LWEC Conference in 2013 (by George Morris) and a high level paper is in preparation.
ISEE Conference Abstracts
Introduction A high proportion of the UK population has been reported as allergic to pollen. Thes... more Introduction A high proportion of the UK population has been reported as allergic to pollen. These have increased in prevalence in the UK population quickly over the last 20 years. Pollen from tree...
Ethnicity & disease, 2010
Community Health Centers (CHCs) are the nation's primary care safety net for vulnerable popul... more Community Health Centers (CHCs) are the nation's primary care safety net for vulnerable populations, including racial/ethnic minorities, immigrants, migrant workers, and those who are uninsured. Women from such population sub-groups contribute disproportionately to cervical cancer incidence, morbidity, and mortality due, in large part, to the underutilization of Papanicolau (Pap) smear screening. Routine Pap smear screening can detect the onset and prevent progression of cervical malignancies. This article reports findings of a cross-sectional study to investigate the association between Pap smear compliance and patient race/ethnicity, insurance, and age for more than 60,000 women seen in a network of CHCs in Florida. Results of this study indicated a strong association between race/ ethnicity and Pap smear screening in CHCs. Among women aged 21-45 years, Hispanics were twice as likely to receive Pap smear screening, while Blacks were 1.45 times more likely to receive Pap smear ...