Browsing by Author "O'Palka, Jacquelynn"
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Item Associations between Two Dietary Quality Scores and Pancreatic Cancer Risk in a US National Prospective Cohort Study(Taylor & Francis, 2024) Hoyt, Margaret; Song, Yiqing; Gao, Sujuan; O'Palka, Jacquelynn; Zhang, Jianjun; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthObjective Most previous studies investigated the associations between intake of individual nutrients and risk of disease, which failed to consider the potential interactions and correlations between various nutrients contained in food. Although dietary quality scores provide a comprehensive evaluation of the entire diet, it remains elusive whether they are associated with the risk of pancreatic cancer. Methods Dietary intake data collected with the Dietary Questionnaire (DQX) and Diet History Questionnaire (DHQ) were used to calculate HEI-2015 and DQI-R scores for participants in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. A high score indicates an increased intake of adequacy components and a decreased intake of moderation components. This study included 252 cases of pancreatic cancer documented from 58,477 persons during a median follow-up of 12.2 years in the DQX cohort and 372 cases of pancreatic cancer ascertained from 101,721 persons during a median follow-up of 8.9 years in the DHQ cohort. Cox proportional hazards regression analysis was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between the two dietary quality scores and pancreatic cancer risk. Results After adjustment for confounders, HEI-2015 and DQI-R scores were not significantly associated with pancreatic cancer risk. However, a significantly lower risk was observed for overweight persons with a higher HEI-2015 score in the DQX cohort (HR [95% CI] comparing the highest with lowest tertile: 0.52 [0.32, 0.85], p for trend = 0.009) and those with higher scores of some individual components. Conclusion Collectively, overall dietary quality is not associated with an altered risk of pancreatic cancer in this US population.Item Beverage consumption and the incidence of overweight and obesity in an Indianapolis WIC population(2016-08-19) Foster, Joshua J.; O'Palka, Jacquelynn; Blackburn, Sara; Li, WeiThe incidence of overweight and obesity in children and adolescence is a global health concern. The long term health implications of overweight or obesity include respiratory issues, mobility joint issues, cardiovascular disease, type II diabetes, and certain types of cancer. The incidence of overweight and obesity is more common in low socioeconomic populations. Though there are many factors influencing children who become overweight or obese, beverage consumption is of particular interest since it is hypothesized that the energy supplied by beverages is not compensated by energy intake from the rest of the diet.Item Comparison of Intravenous Lipid Emulsions in Parenteral Nutrition: A Pilot Study(2021-02) McGuigan, Alexis K.; O'Palka, Jacquelynn; Blackburn, Sara; Laughlin, Michelle; Carter, AmyBackground: SMOF lipid™ infusion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil has been approved and recommended for use in adults receiving parenteral nutrition (PN). Research shows that SMOF lipid infusion is safe for use in post-operative and critically ill patients. Improved patient outcomes are linked to SMOF lipid use over traditional soybean oil lipid emulsions. Objective: The purpose of this study was to determine the effect of SMOF lipid infusion on incidence of infection, ICU length of stay, hospital length of stay, and mortality in adult trauma patients as compared to parenteral nutrition utilizing 100% soybean oil emulsion or a lipid-free, dextrose and amino acid administration. Methods and Analysis: A retrospective chart review was conducted for adult trauma patients admitted to Eskenazi Health’s surgical intensive care unit (SICU) that received PN from May 2017 to May 2020. Data were collected from the electronic health record and trauma registry. Results: Twenty-nine patients were included who met study criteria: 17 patients in the traditional lipid cohort and 12 in the SMOF lipid cohort. The length of PN therapy was comparable between the traditional and SMOF ILE groups, 13.9 days (± 11.5) and 13.3 days (± 14.3) respectively. All 12 patients in the SMOF lipid cohort received intravenous lipid emulsion (ILE) compared to 42% (n=7) of traditional lipid group patients (p=0.001). SMOF treatment group were provided 100% of estimated energy needs via PN compared to an average of 94% (± 9.7) of estimated energy needs in the traditional lipid treatment group (p=0.036). Incidence of infection during initial hospitalization was significantly lower in the SMOF treatment group (n=3, 25%) compared to the traditional lipid treatment group (n=13, 76%). Mortality was decreased in the SMOF treatment group (0%) when contrasted to the Intralipid treatment group (23.5%), p=0.04. Conclusion: Patients receiving SMOF lipid emulsion within PN therapy had better clinical outcomes compared to those receiving Intralipid soybean-lipid emulsion or a dextrose and amino acid administration.Item The Impact of a Growth Measurement Training Program on the Use of Length Boards in a Newborn Intensive Care Unit(2021-07) Thornton, Jessica Lynn; Blackburn, Sara; Denne, Scott; O'Palka, JacquelynnObjective: Nutritional assessment of infants in the Newborn Intensive Care Unit (NICU) depends on the performance of accurate, serial anthropometric measurements. In this Level IV NICU, nurses used tape measures more often than length boards making the length measurements inaccurate. The purpose of this study is to determine if an in-person, hands-on length board training program versus a self-instruction poster education, increases the use of length boards to measure length in NICU infants. Methods: Two nursing in-service education training sessions on how to correctly use a length board were held with the NICU staff over two separate two (2-week) periods. One session consisted of a self-direct education training method. The second education method was an in-person interactive learning experience with hands on practice. At the end of each education session, the participants completed the same four-question post-test. One month later, data was collected for one month following each of the training periods on the tool used to obtain linear measurements on infants in the NICU. Statistics: A 2x2 contingency table was constructed using the two qualitative variables of length board uses after the poster education versus length board uses after the live in-service education. Analysis was performed using SAS 9.4 ™ statistical software. Chi squared equals 93.980 with 1 degree of freedom. P-value <0.0001. Results: The month following the self-directed poster education, two hundred ninety-one (291) or 92% measurements were obtained using a tape measure and 19 (7%) obtained using a length board. The month following the interactive, in-service training, one hundred forty-eight (148) or 57% measurements were obtained using a tape measure and 105 (41%) with a length board. Thirty five percent (35%) more length measurements were obtained using a length board after the line in-service training (P-value <0.0001). Conclusion: Nurses in a Level IV Newborn Intensive Care Unit utilized length boards significantly more after a live in-service education than after a self-directed education.Item The Impact of Online Nutrition Education on WIC Client Retention and Redemption of the Cash Value Benefit of Fruit and Vegetables(2021-06) Gray, Sara Michelle; O'Palka, Jacquelynn; Blackburn, Sara A.; Magee, PaulaAll participants of the Indiana Special Supplemental Nutrition Program for Women Infant and Children (WIC) receive supplemental foods, nutrition education, and health care referrals. The Indiana WIC program established an online nutrition education program to help eliminate barriers to participants who are unable to be physically present for their second nutrition education appointments. The aim of this study was to compare the participation of WIC participants enrolled in standard in-person appointments with WIC participants enrolled in the Online Nutrition Education (ONE) pilot program by assessing the completion of the ONE lessons and the cash value benefit usage at 3 months after participants’ acceptance into the WIC program. A quasi-experiment was performed using a time series comparison of WIC participant attendance at their in-person nutrition education appointment to participants completion of an online nutrition education lesson. A second comparison of the two groups observed the participants redemption of their cash value benefit on fruits and vegetables (CVB). The increase in participation from 2019 to 2020 was statistically significant (P=0.035). Analysis showed that there was a significant difference (P ≤ 0.001) between the 2019 and 2020 CVB mean redemption rates. This study provides evidence that WIC participants are more likely to maintain their participation when offered the addition of an online nutrition education appointment type.Item Intake of Calcium, Magnesium, and Phosphorus and Risk of Pancreatic Cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial(Taylor & Francis, 2021) Hoyt, Margaret; Song, Yiqing; Gao, Sujuan; O'Palka, Jacquelynn; Zhang, Jianjun; Epidemiology, School of Public HealthObjectiveFew epidemiological studies have investigated the associations between calcium, magnesium, and phosphorus intake and pancreatic cancer. We examined these associations in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.MethodsDiet was assessed using the Dietary Questionnaire (DQX) at baseline in the intervention arm and the Dietary History Questionnaire (DHQ) in 1999 or around the third anniversary of randomization in both the intervention and control arms. During a median follow-up of 12.2 years, 279 cases of pancreatic cancer occurred from 58,477 participants who completed DQX; 380 cases arose from 101,622 participants who responded to DHQ over a median follow-up of 8.9 years. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI).ResultsTotal calcium intake was inversely associated with pancreatic cancer [HR (95% CI) for the fourth vs. the first quartiles in the DHQ cohort: 0.67 (0.47, 0.96); p-trend: 0.035]. An inverse association was also observed for total magnesium intake [HR (95% CI) for the fourth vs. the first quartiles in the DQX cohort: 0.61 (0.37, 1.00); p-trend: 0.023]. Reduced risk associated with total calcium intake was confined to subjects with a high fat intake (>73 g/day) in the DHQ cohort (p-interaction: 0.16).ConclusionsThere was not a significant association between dietary phosphorus intake and pancreatic cancer risk in both cohorts. Total intake of calcium and magnesium are associated with a lower pancreatic cancer risk. The effect of total calcium intake was modified by fat intake.Item Measuring the Impact of Curriculum-Integrated Librarian Instruction on Dietetic Interns’ Evidence-Based Nutrition Practice Knowledge(Journal of the American Academy of Nutrition and Dietetics, 2020-09) Hinrichs, Rachel J.; O'Palka, Jacquelynn; Blackburn, SaraItem Mineral Intake, Dietary Quality, and Body Adiposity in Relation to Pancreatic Cancer Risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial(2022-08) Hoyt, Margaret Leeann; Zhang, Jianjun; Song, Yiqing; Gao, Sujuan; O'Palka, JacquelynnPancreatic cancer is the third leading cause of cancer-related deaths and is projected to rank second by 2030 in the United States. However, the etiology of this malignancy remains elusive, with family history, chronic pancreatitis, type 2 diabetes, and cigarette smoking as only established risk factors. Therefore, it is urgent and important to identify risk factors, especially modifiable ones (e.g. diet), for the primary prevention of this lethal disease. In this dissertation, we have investigated the associations of mineral intake, dietary quality, and body adiposity with the risk of pancreatic cancer among participants in the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial. Calcium, magnesium, and phosphorus are essential minerals that modulate energy metabolism and glucose homeostasis and may thus be involved in pancreatic carcinogenesis. In the first manuscript, we found that total calcium intake was associated with a reduced risk of pancreatic cancer. In addition, a significant linear inverse association was observed for total magnesium intake. The Healthy Eating Index, 2015 (HEI-2015) and the Dietary Quality Index- revised (DQI-R) have been developed to assess the overall quality or patterns of diet. In the second manuscript, we did not find significant associations between HEI-2015 or DQI-R scores and pancreatic cancer risk. However, a higher intake of some score components (i.e., calcium, vegetables, and whole grains) conferred a lower risk. Although mounting biological mechanisms have linked overweight and obesity to the development of pancreatic cancer, it is largely unclear whether prediagnostic body mass index (BMI) trajectory is associated with the risk of this disease. In the third manuscript, we revealed that prediagnostic adulthood BMI trajectory was not associated with pancreatic cancer risk, but a suggestively or significantly increased risk were identified for individuals who were overweight at age 20 or obese at age 50, compared with those who had a normal weight at the two respective time points. Taken together, the findings of research presented in this dissertation contribute to an improved understanding of the crucial roles of diet and adiposity in the etiology of pancreatic cancer, which may offer some new avenues for the prevention of this intractable malignancy.