Post-diagnosis Changes in Polycyclic Aromatic Hydrocarbon Sources of Exposure and Survival Following Breast Cancer

In 2016, an estimated 246,000 women will be diagnosed with, and 40,000 deaths will be attributed to, breast cancer. Polycyclic Aromatic Hydrocarbons (PAHs), a group of over 100 different chemicals formed during the incomplete combustion of organic substances, may influence survival after breast cancer. This dissertation examined whether the primary sources of PAH exposure, tobacco smoke and intake of grilled/smoked meat, and changes in exposure after diagnosis were associated with mortality after breast cancer. To address the dissertation aims, I utilized resources from the Long Island Breast Cancer Study Project (LIBCSP), a population-based cohort study of 1,508 women who were diagnosed with first primary breast cancer in 1996/1997. Women were interviewed at baseline, shortly after diagnosis, and again five years later and have been followed for 18+ years using the National Death Index. Results of Aim 1A showed that smoking in the year before diagnosis was associated with a 69% increased risk of long-term all-cause mortality, but not breast cancer-specific mortality. Among women who continued smoking after breast cancer, risk of all-cause mortality was elevated by 130%, but this was attenuated by approximately 20% among women who quit smoking after diagnosis. Results of Aim 1B examining environmental tobacco smoke exposure were largely null, a finding that is in agreement with few studies conducted to date examining at-diagnosis ETS exposure. Results of Aim 2 showed that at-diagnosis high intake of total grilled/barbecued and smoked meat was associated with a 23% increased risk of all-cause mortality. At-diagnosis intake of smoked beef/lamb/pork was positively associated with all-cause and breast cancer mortality, while intake of smoked poultry/fish was inversely associated with mortality. Women with continued high post-diagnosis intake of grilled/barbecued and smoked meat had a further elevated risk of all-cause mortality; risk increased from 23% to 31%. Consistent with the associations observed for at-diagnosis intake, risk of breast cancer-specific mortality was inversely associated with high post-diagnosis intake of smoked poultry/fish. The results of this dissertation help strengthen smoking cessation efforts and inform the limited dietary intake guidelines currently available for the more than 3 million women who are survivors of breast cancer.Doctor of Philosoph

Latino fathers’ feeding-related parenting strategies on children’s eating

This study examined father and child socio-demographic characteristics in relation to fathers’ feeding-related parenting strategies and whether his parenting strategies were associated with children’s-reported fruit and vegetable (FV), weekly fast food, and daily sugar-sweetened beverage intake among 81 Latino fathers-children pairs. Fathers’ employment status, acculturation, number of children in the home, and child’s age and weight status were associated with the use of different parenting strategies. Additionally, more control was associated with less FV intake, but more reinforcement was associated with more FV intake by children. Fathers play a role in their children’s diet and should be considered in future interventions

Building knowledge from the epistemology of the South: the importance of training researchers in initial teacher training

This study aims to reflect on the importance of considering epistemologies of the South and research training as benchmarks in the initial teacher of educators in the Latin American context. In recent years, there has been a growing recognition of the need to diversify and decolonize knowledge production in education, especially in the Global South. The epistemology of the South provides a conceptual framework that challenges traditional Eurocentric perspectives and promotes alternative ways of knowing and understanding education. To achieve the research objective, a literature review was conducted focusing on key concepts such as Southern epistemology, researcher training, and initial teacher education. The review encompassed academic articles, books and relevant theoretical frameworks. Content analysis techniques were employed to critically examine the literature, identifying themes, theoretical perspectives, and implications for research training in Initial Teacher Education (ITE). The findings of this study suggest that the incorporation of the epistemology of the South into researcher training can have a transformative impact on the educational sector. By adopting ways of knowing and understanding, future researchers can develop a more nuanced and contextualized understanding of educational phenomena. This approach promotes critical thinking skills and encourages researchers to question dominant narratives and power structures in education. Additionally, the study highlights the importance of integrating research training into initial teacher education. By fostering the development and consolidation of research skills and a critical mindset in future teachers, it promotes their transformation into change agents within the Latin American educational system in which they operate. From this perspective, research-oriented teacher training programs empower educators to engage in evidence-based practices, contribute to educational research, and advocate for pedagogical approaches that respond to local contexts and social realities in which they act. This study underscores the need to integrate Southern epistemologies and research training within into initial teacher education. By doing so, we can nurture a new generation of educators with critical thinking skills capable of effecting significant societal changes. This research contributes to the ongoing dialogue on the decolonization of education and promotes the development of inclusive and contextually relevant educational practices

Recruiting Diverse Smokers: Enrollment Yields and Cost

To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3–7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers

Genetic polymorphisms of phase I metabolizing enzyme genes, their interaction with lifetime grilled and smoked meat intake, and breast cancer incidence

To examine associations between 22 CYP single nucleotide polymorphisms (SNPs) and breast cancer incidence and their interactions with grilled–smoked meat intake, a source of polycyclic aromatic hydrocarbons

Effect of Pictorial Cigarette Pack Warnings on Changes in Smoking Behavior: A Randomized Clinical Trial

Pictorial warnings on cigarette packs draw attention and increase quit intentions, but their effect on smoking behavior remains uncertain

Polychlorinated biphenyls and their association with survival following breast cancer

Polychlorinated biphenyls (PCBs) are hypothesized to influence breast carcinogenesis due to their persistence and potential to induce estrogenic and anti-estrogenic effects. Whether PCBs influence survival following breast cancer is unknown

Environmental Tobacco Smoke Exposure and Survival Following Breast Cancer

Environmental tobacco smoke (ETS) exposure is hypothesized to influence survival after breast cancer, but few studies have examined this association