Academic Appointments

Honors & Awards

  • Distinguished Faculty Award Winner: Distinguished Educator/Mentor, University of Chicago Biological Sciences Division (2013)

Professional Education

  • BSc, Princeton University, Biology (1992)
  • PhD, Stanford University, Biology (1998)

Current Research and Scholarly Interests

Our research program is focused on the physical and mental health of active-duty U.S. Army soldiers. We have developed the Stanford Military Data Repository (SMDR) in collaboration with colleagues at the Army's Office of the Surgeon General to enable large-scale cohort studies addressing disability, heat injury, musculoskeletal injuries, pregnancy outcomes, and behavioral health outcomes among soldiers.

All Publications

  • Timing and Predictors of Mild and Severe Heat Illness among New Military Enlistees. Medicine and science in sports and exercise Nelson, D. A., Deuster, P. A., OʼConnor, F. G., Kurina, L. M. 2018


    PURPOSE: Heat illnesses are important and potentially fatal conditions among physically active individuals. We determined predictors of heat illness among enlistees in a large military population experiencing common physical activity patterns.METHODS: We estimated the adjusted odds of mild and severe heat illness associated with demographic, health-related, and geographic factors among active-duty, United States Army soldiers enlisting between January 2011 - December 2014 (N=238,168) using discrete-time multivariable logistic regression analyses.RESULTS: We observed 2,612 incident cases of mild heat illness (MHI) and 732 incident cases of severe heat illness (SHI) during 427,922 person-years of follow-up, with a mean and median of 21.6 and 21 months per subject. During the first six duty months, 71.3% of the MHIs and 60.2% of the SHIs occurred, peaking at month two. The odds of MHI quadrupled among those with prior SHI (OR=4.02, 95% confidence interval [CI]: 2.67 - 6.03). Body mass index (BMI) extremes increased risk substantially (ORs at BMI ≥30: for MHI, 1.41, CI 1.19 - 1.67; for SHI, 1.94, CI 1.47 - 2.56; ORs at BMI <18.5: for MHI, 1.50, CI 1.01 - 2.21; for SHI, 2.26, CI 1.16 - 4.39). Tobacco use was associated with a 55% increase (CI: 1.37 - 1.77) in MHI odds. The odds of MHI increased if taking NSAIDs, opioids or methylphenidate stimulants. Lower age and lower entry aptitude scores were associated with progressively increased MHI odds.CONCLUSION: The majority of heat illnesses occurred at the outset of service, indicating the need for focused prevention methods at the initiation of military duty. Prior heat illness, BMI extremes, medications and tobacco use represent potentially actionable risk factors to address by education, policy, and/or clinician intervention.

    View details for DOI 10.1249/MSS.0000000000001623

    View details for PubMedID 29613996

  • Sickle Cell Trait and Heat Injury Among US Army Soldiers AMERICAN JOURNAL OF EPIDEMIOLOGY Nelson, D., Deuster, P. A., O'Connor, F. G., Kurina, L. M. 2018; 187 (3): 523–28


    There is concern that sickle cell trait (SCT) increases risk of exertional collapse, a primary cause of which is heat injury. However, to our knowledge, no population-based studies among active individuals have addressed this, representing a critical evidence gap. We conducted a retrospective cohort study of SCT-tested African-American soldiers who were on active duty in the US Army anytime between January 2011 and December 2014. Using Cox proportional hazards models and adjusting for demographic and medical factors, we observed no significant associations between SCT and either mild heat injury (hazard ratio (HR) = 1.15, 95% confidence interval (CI): 0.84, 1.56; n = 45,999) or heat stroke (HR = 1.11, 95% CI: 0.44, 2.79; n = 46,183). Risk of mild heat injury was substantially higher among soldiers with recent prescriptions for antipsychotic agents (HR = 3.25, 95% CI: 1.33, 7.90). Risk of heat stroke was elevated among those with a prior mild heat injury (HR = 17.7, 95% CI: 8.50, 36.7) and among overweight and obese individuals (HR = 2.91 (95% CI: 1.38, 6.17) and HR = 4.04 (95% CI: 1.72, 9.45), respectively). In a setting where universal precautions are utilized to mitigate risk of exertion-related illnesses, SCT is not associated with either mild heat injury or heat stroke.

    View details for DOI 10.1093/aje/kwx285

    View details for Web of Science ID 000426812300016

    View details for PubMedID 29020197

  • Deployment and Preterm Birth Among United States Army Soldiers American Journal of Epidemiology Shaw, J. G., Nelson, D. A., Shaw, K. A., Woolaway-Bickel, K., Phibbs, C. S., Kurina, L. M. 2018: 687–95


    With increasing integration of women into combat roles in the US military, it is critical to determine whether deployment, which entails unique stressors and exposures, is associated with adverse reproductive outcomes. Few studies have examined whether deployment increases the risk of preterm birth; no studies (to our knowledge) have examined a recent cohort of servicewomen. We therefore used linked medical and administrative data from the Stanford Military Data Repository for all US Army soldiers with deliveries between 2011 and 2014 to estimate the associations of prior deployment, recency of deployment, and posttraumatic stress disorder with spontaneous preterm birth (SPB), adjusting for sociodemographic, military-service, and health-related factors. Of 12,877 deliveries, 6.1% were SPBs. The prevalence was doubled (11.7%) among soldiers who delivered within 6 months of their return from deployment. Multivariable discrete-time logistic regression models indicated that delivering within 6 months of return from deployment was strongly associated with SPB (adjusted odds ratio = 2.1, 95% confidence interval: 1.5, 2.9). Neither multiple past deployments nor posttraumatic stress disorder was significantly associated with SPB. Within this cohort, timing of pregnancy in relation to deployment was identified as a novel risk factor for SPB. Increased focus on servicewomen's pregnancy timing and predeployment access to reproductive counseling and effective contraception is warranted.

    View details for DOI 10.1093/aje/kwy003

    View details for PubMedCentralID PMC5889029

  • Objective Effects of Breast Reduction Surgery on Physical Fitness. Annals of plastic surgery Knox, J. A., Nelson, D. A., Latham, K. P., Kurina, L. M. 2017


    BACKGROUND: Reduction mammaplasty is known for excellent outcomes and patient satisfaction. Although patients report improvements in pain, weight loss, and exercise levels, objective data on physical fitness benefits are limited.METHODS: Using the Stanford Military Data Repository, we identified 89 US Army active duty women with at least 1 pre- and postoperative Army Physical Fitness Test (APFT) who underwent reduction mammaplasty during 2011 to 2014. We used paired t tests to compare pre- and postoperative APFT score means and raw values for push-ups, sit-ups, and the 2-mile run.RESULTS: There were 56 subjects (62.9%) who improved in total APFT scores. Total score means increased from 235.9 preoperatively to 243.4 postoperatively (P = 0.0065). Of 28 subjects with at least 2 APFT scores before and after surgery, 20 (71.4%) improved in total scores. The subgroup's mean total score increased from 237.8 to 251.3 (P = 0.0009). Comparing individual pre- and postprocedure APFTs, all subjects demonstrated a mean 3.9% (SD, 0.1) improvement in total scores, and the subpopulation of 28 improved by 6.3% (SD, 0.1). In all events, mean performance values trended toward better postoperative scores. Differences were statistically significant for the total population for the number of sit-ups (P = 0.035), and, for the subgroup of 28, differences were statistically significant for the total score (P = 0.0009), sit-ups (P = 0.0002), and push-ups (P = 0.0134).CONCLUSIONS: Reduction mammaplasty was associated with postoperative physical fitness improvements among US Army active duty women. Soldier data are useful for objectively assessing physical fitness effects of breast reduction surgery.

    View details for DOI 10.1097/SAP.0000000000001167

    View details for PubMedID 28650408

  • Long-Acting Reversible Contraceptive Placement Among Active-Duty U.S. Army Servicewomen. Obstetrics and gynecology Erickson, A. K., Nelson, D. A., Shaw, J. G., Loftus, P. D., Kurina, L. M., Shaw, K. A. 2017; 129 (5): 800-809


    To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake.This retrospective cohort study used the Stanford Military Data Repository, which includes all digitally recorded health encounters for active-duty U.S. Army soldiers from 2011 to 2014. We analyzed data from women aged 18-44 years to assess rates of LARC initiation using medical billing codes. We then evaluated predictors of LARC initiation using multivariable regression.Among 114,661 servicewomen, 14.5% received a LARC method; among those, 60% received an IUD. Intrauterine device insertions decreased over the study period (38.7-35.9 insertions per 1,000 women per year, β=0.14, 95% confidence interval [CI] -0.23 to -0.05, P<.05), whereas LARC uptake increased, driven by an increase in implant insertions (20.3-35.4/1,000 women per year, β=0.41, CI 0.33-0.48, P<.001). Younger age was a positive predictor of LARC uptake: 32.4% of IUD users and 62.6% of implant users were in the youngest age category (18-22 years) compared with 9.6% and 2.0% in the oldest (36-44 years). The likelihood of uptake among the youngest women (compared with oldest) was most marked for implants (adjusted relative risk 7.12, CI 5.92-8.55; P<.001). A total of 26.2% of IUD users had one child compared with 13.2% among non-LARC users (adjusted relative risk 1.94, CI 1.85-2.04, P<.001). The majority (52.2%) of those initiating IUDs were married, which was predictive of uptake over never-married women (adjusted relative risk 1.52, CI 1.44-1.59, P<.001).Among servicewomen, we observed low but rising rates of LARC insertion, driven by increasing implant use. Unmarried and childless soldiers were less likely to initiate LARC. These findings are consistent with potential underutilization and a need for education about LARC safety and reversibility in a population facing unique consequences for unintended pregnancies.

    View details for DOI 10.1097/AOG.0000000000001971

    View details for PubMedID 28383371

  • Sickle Cell Trait, Rhabdomyolysis, and Mortality among U.S. Army Soldiers. New England journal of medicine Nelson, D. A., Deuster, P. A., Carter, R., Hill, O. T., Wolcott, V. L., Kurina, L. M. 2016; 375 (5): 435-442


    Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional rhabdomyolysis, in a large population of active persons who had undergone laboratory tests for hemoglobin AS (HbAS) and who were subject to exertional-injury precautions.We used Cox proportional-hazards models to test whether the risks of exertional rhabdomyolysis and death varied according to sickle cell trait status among 47,944 black soldiers who had undergone testing for HbAS and who were on active duty in the U.S. Army between January 2011 and December 2014. We used the Stanford Military Data Repository, which contains comprehensive medical and administrative data on all active-duty soldiers.There was no significant difference in the risk of death among soldiers with sickle cell trait, as compared with those without the trait (hazard ratio, 0.99; 95% confidence interval [CI], 0.46 to 2.13; P=0.97), but the trait was associated with a significantly higher adjusted risk of exertional rhabdomyolysis (hazard ratio, 1.54; 95% CI, 1.12 to 2.12; P=0.008). This effect was similar in magnitude to that associated with tobacco use, as compared with no use (hazard ratio, 1.54; 95% CI, 1.23 to 1.94; P<0.001), and to that associated with having a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 30.0 or more, as compared with a BMI of less than 25.0 (hazard ratio, 1.39; 95% CI, 1.04 to 1.86; P=0.03). The effect was less than that associated with recent use of a statin, as compared with no use (hazard ratio, 2.89; 95% CI, 1.51 to 5.55; P=0.001), or an antipsychotic agent (hazard ratio, 3.02; 95% CI, 1.34 to 6.82; P=0.008).Sickle cell trait was not associated with a higher risk of death than absence of the trait, but it was associated with a significantly higher risk of exertional rhabdomyolysis. (Funded by the National Heart, Lung, and Blood Institute and the Uniformed Services University of the Health Sciences.).

    View details for DOI 10.1056/NEJMoa1516257

    View details for PubMedID 27518662

    View details for PubMedCentralID PMC5026312

  • Prediction of all-cause occupational disability among US Army soldiers OCCUPATIONAL AND ENVIRONMENTAL MEDICINE Nelson, D. A., Wolcott, V. L., Kurina, L. M. 2016; 73 (7): 442-451


    Long-term occupational disability rates associated with eventual discharges from military service have risen sharply among active-duty US Army soldiers during the last three decades, with important implications for soldier health and national security alike. To address this problem, we built predictive models for long-term, all-cause occupational disability and identified disability risk factors using a very large, multisource database on the total active-duty US Army.We conducted a cross-temporal retrospective cohort study and used mixed-effects logistic regression models to derive and validate disability risk assignments. The derivation cohort included 510 616 US Army soldiers on duty in December 2012, and the validation cohort included 483 197 soldiers on duty in December 2013.The predictive model yielded an overall c-statistic of 85.97% (95% CI 85.61% to 86.32%). Risk thresholds at the population's 75th and 95th centiles identified 80.53% and 42.08%, respectively, of the disability designations that occurred population wide during the subsequent 9 months. Frequent work excusals, high outpatient care utilisation and psychotropic medication use were the strongest independent predictors of later disability.These findings indicate that predictive models using diverse data types can successfully anticipate long-term occupational disability among US Army soldiers and could be used for disability risk screening.

    View details for DOI 10.1136/oemed-2015-103436

    View details for Web of Science ID 000378094300005

    View details for PubMedID 27129391

  • Sleep duration and health among older adults: associations vary by how sleep is measured JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH Lauderdale, D. S., Chen, J., Kurina, L. M., Waite, L. J., Thisted, R. A. 2016; 70 (4): 361-366
  • Insomnia symptoms and actigraph-estimated sleep characteristics in a nationally representative sample of older adults. journals of gerontology. Series A, Biological sciences and medical sciences Chen, J., Waite, L., Kurina, L. M., Thisted, R. A., McClintock, M., Lauderdale, D. S. 2015; 70 (2): 185-192


    Reports of insomnia symptoms are common among the elderly. However, little is known about the relationship between insomnia symptoms and objective assessments of sleep in the general population of older adults. We assessed concordance between insomnia symptoms and actigraphic sleep characteristics in a nationally representative sample of older Americans.In a national probability sample of 727 adults aged 62-91 years in 2010-2011 from the National Social Life, Health, and Aging Project, respondents were asked how often they (a) feel rested when they wake up, (b) have trouble falling asleep, (c) have trouble with waking up during the night, and (d) have trouble waking up too early and not being able to fall asleep again. Responses to these questions were compared to sleep characteristics estimated from three nights of actigraphy for the same individuals. Statistical analyses were adjusted for age, gender, race and ethnicity, income, assets, and education.Feeling rested (Question (a), above) was not correlated with any actigraphy-estimated sleep characteristics. Questions (b)-(d) each had several significant correlations with the actigraphy metrics, but generally not with the specific objective sleep characteristics that each question intended to reference. In some cases, the associations were not in the expected direction.Although three of four questions about insomnia symptoms were significantly associated with objectively estimated sleep characteristics, responses seem to be general indicators of sleep quality rather than reports of specific sleep characteristics.

    View details for DOI 10.1093/gerona/glu144

    View details for PubMedID 25199910

  • Assessment of Sleep in the National Social Life, Health, and Aging Project JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES Lauderdale, D. S., Schumm, L. P., Kurina, L. M., McClintock, M., Thisted, R. A., Chen, J., Waite, L. 2014; 69: S125-S133
  • Exploring entrustment: housestaff autonomy and patient readmission. American journal of medicine Martin, S. K., Farnan, J. M., Flores, A., Kurina, L. M., Meltzer, D. O., Arora, V. M. 2014; 127 (8): 791-797

    View details for DOI 10.1016/j.amjmed.2014.04.013

    View details for PubMedID 24802021

  • Clinical prediction of musculoskeletal-related "medically not ready" for combat duty statuses among active duty U.S. army soldiers. Military medicine Nelson, D. A., Kurina, L. M. 2013; 178 (12): 1365-1372


    No evidence-based mechanism currently exists to inform U.S. Army clinicians of soldiers at risk of being found "Medically Not Ready" for combat duty. Historically, musculoskeletal conditions represent high-frequency medical problems among Army soldiers. We explored the feasibility of using centrally archived medical and administrative data on Army soldiers in the automated prediction of musculoskeletal-related Medically Not Ready soldiers who did not deploy. We examined 56,443 active duty U.S. Army soldiers who underwent precombat medical screening during March through December 2009 and in March 2010. Musculoskeletal problems were associated with 23.0% of nonreadiness cases in the study population. We used multivariable logistic regression in derivation cohorts to compute risk coefficients and cut points. We then applied these coefficients to covariates in validation cohorts, simulating predictions 2 to 3 months before their medical screenings. The analysis yielded c statistics ranging from 83 to 90%. The predictions identified 45 to 73% and 50 to 82% of the individual male and female outcome-positive soldiers, respectively, while obtaining 83 to 95% specificity. Our findings demonstrate the potential of Army data to create evidence-based estimates of nonreadiness risk. These methods could enable earlier patient referrals and improved management, and potentially reduce medically related nondeployment.

    View details for DOI 10.7205/MILMED-D-13-00182

    View details for PubMedID 24306021

  • Sleep duration and all-cause mortality: a critical review of measurement and associations ANNALS OF EPIDEMIOLOGY Kurina, L. M., McClintock, M. K., Chen, J., Waite, L. J., Thisted, R. A., Lauderdale, D. S. 2013; 23 (6): 361-370


    Variation in sleep duration has been linked with mortality risk. The purpose of this review is to provide an updated evaluation of the literature on sleep duration and mortality, including a critical examination of sleep duration measurement and an examination of correlates of self-reported sleep duration.We conducted a systematic search of studies reporting associations between sleep duration and all-cause mortality and extracted the sleep duration measure and the measure(s) of association.We identified 42 prospective studies of sleep duration and mortality drawing on 35 distinct study populations worldwide. Unlike previous reviews, we find that the published literature does not support a consistent finding of an association between self-reported sleep duration and mortality. Most studies have employed survey measures of sleep duration, which are not highly correlated with estimates based on physiologic measures.Despite a large body of literature, it is premature to conclude, as previous reviews have, that a robust, U-shaped association between sleep duration and mortality risk exists across populations. Careful attention must be paid to measurement, response bias, confounding, and reverse causation in the interpretation of associations between sleep duration and mortality.

    View details for DOI 10.1016/j.annepidem.2013.03.015

    View details for Web of Science ID 000319782700010

    View details for PubMedID 23622956

  • Loneliness Is Associated with Sleep Fragmentation in a Communal Society SLEEP Kurina, L. M., Knutson, K. L., Hawkley, L. C., Cacioppo, J. T., Lauderdale, D. S., Ober, C. 2011; 34 (11): 1519-1526


    Loneliness has been shown to predict poor health. One hypothesized mechanism is that lonely individuals do not sleep as well as individuals who feel more connected to others. Our goal was to test whether loneliness is associated with sleep fragmentation or sleep duration.Cross-sectional study.Members of a traditional, communal, agrarian society living in South Dakota.Ninety-five participants (mean age 39.8 years, 55% female) who were ≥ 19 years of age at the study's inception.Not applicable.We conducted interviews querying loneliness, depression, anxiety, and stress, as well as subjective sleep quality and daytime sleepiness. Study participants wore a wrist actigraph for one week to measure objective sleep properties; the two studied here were sleep fragmentation and sleep duration. Higher loneliness scores were associated with significantly higher levels of sleep fragmentation (β = 0.073, t = 2.55, P = 0.01), controlling for age, sex, body mass index, risk of sleep apnea, and negative affect (a factor comprising symptoms of depression and anxiety, and perceived stress). Loneliness was not associated with sleep duration or with either subjective sleep measure.Loneliness was a significant predictor of sleep fragmentation. Humans' social nature may partly be manifest through our dependence on feeling secure in our social environment to sleep well.

    View details for DOI 10.5665/sleep.1390

    View details for Web of Science ID 000296727200013

    View details for PubMedID 22043123

  • Sex-specific genetic architecture of asthma-associated quantitative trait loci in a founder population CURRENT ALLERGY AND ASTHMA REPORTS Ober, C., Pan, L., Phillips, N., Parry, R., Kurina, L. A. 2006; 6 (3): 241-246


    Identifying genes that influence susceptibility to asthma-related and atopy-related phenotypes has been challenging, owing to clinical heterogeneity and a complex underlying genetic architecture that includes both gene-gene and gene-environment interactions. In this article, we report the results of genome-wide linkage and association studies of eight asthma-associated quantitative traits in the Hutterites, a founder population of European descent. Our study revealed significant sex-specific genetic architecture for at least five of these traits, and identified 13 genome-wide significant quantitative trait loci (QTL) by linkage or association that are present in only one of the sexes (nine in males, four in females).

    View details for Web of Science ID 000242004400009

    View details for PubMedID 16579875

  • Schizophrenia and cancer: an epidemiological study BRITISH JOURNAL OF PSYCHIATRY Goldacre, M. J., Kurina, L. M., Wotton, C. J., Yeates, D., Seagroatt, V. 2005; 187: 334-338


    For decades there has been interest in the possibility that people with schizophrenia might have some protection against cancer, and that, if this were so, it might hold clues about aetiological mechanisms in schizophrenia.To study cancer incidence in schizophrenia.Cohort analysis of linked hospital and death records was used to compare cancer rates in people with schizophrenia with a reference cohort.We did not find a reduced risk for cancer overall (rate ratio 0.99,95% CI 0.90-1.08) or for most individual cancers. There was, however, a significantly low rate ratio for skin cancer (0.56,95% CI 0.36-0.83).We found no evidence that schizophrenia confers protection against cancer in general. Low rates of cancer are consistent with the hypothesis that sun exposure may influence the development of schizophrenia, although other explanations are also possible.

    View details for Web of Science ID 000232483500008

    View details for PubMedID 16199792

  • Sex differences in the genetic basis of morning serum cortisol levels: Genome-wide screen identifies two novel loci specific to women JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM Kurina, L. M., Weiss, L. A., Graves, S. W., Parry, R., Williams, G. H., Abney, M., Ober, C. 2005; 90 (8): 4747-4752


    Relatively little is known about the influence of specific genes on cortisol levels, particularly morning cortisol levels.The objective of this study was to identify quantitative trait loci associated with morning serum cortisol levels.We carried out a genome screen for morning serum cortisol using linkage and association methods tailored for use in large pedigrees. We conducted these analyses both in the whole sample and partitioned by sex.This study was conducted on nine communal Hutterite farms in South Dakota.The Hutterites are a young founder population who practice a communal, farming lifestyle in the western United States and in Canada. Hutterites (n = 504, 53% female) aged 11-89 yr from a single pedigree participated in this study.The main outcome measures were markers significantly linked or associated with variation in morning serum cortisol levels.One genome-wide significant association was identified in the whole sample on 11p (D11S1981, P = 0.000092). Results of sex-partitioned analyses indicated that this association was restricted to females (females, P = 0.000084; males, P = 0.20). The 146-bp allele at this locus accounted for 7% of the variance in morning cortisol values in females, and females homozygous for the allele had an 89% increase in morning cortisol levels compared with female noncarriers. A second genome-wide significant association in females was identified on 14q (D14S74, P = 0.000091).Our results suggest that the genetic determinants of morning cortisol levels may be different for men and women and that loci on 11p and 14q influence morning cortisol levels in women.

    View details for DOI 10.1210/jc.2005-0384

    View details for Web of Science ID 000231068500048

    View details for PubMedID 15941864

  • The effect of menopause on grip and pinch strength: Results from the Chicago, Illinois, site of the Study of Women's Health Across the Nation AMERICAN JOURNAL OF EPIDEMIOLOGY Kurina, L. M., Gulati, M., Everson-Rose, S. A., Chung, P. J., Karavolos, K., COHEN, N. J., Kandula, N., Lukezic, R., Dugan, S. A., Sowers, M., Powell, L. H., Pickett, K. E. 2004; 160 (5): 484-491


    Women may experience a decline in physical function during menopause. Whether this decline is due to aging or to changes in hormonal status is unknown. The authors performed a longitudinal data analysis on data collected between 1996 and 2001 to determine the effects of menopausal status, age, race, and use of hormone replacement therapy (HRT) on 3-year changes in grip and pinch strength. Participants were 563 women from the Chicago, Illinois, site of the Study of Women's Health Across the Nation. According to adjusted analyses, women who became postmenopausal showed a 1.04-kg decline in grip strength (p = 0.10) and a 0.57-kg decline in pinch strength (p = 0.002) relative to women who remained premenopausal. Women who became early perimenopausal showed a 0.20-kg decline in pinch strength (p = 0.04), whereas women who transitioned to late perimenopause showed a 0.93-kg decline in grip strength (p = 0.07). Effects of menopausal status on grip and pinch strength did not vary by race. A significant HRT-by-race interaction for grip strength was found; African-American HRT users had greater grip strength during the study, whereas Caucasian HRT users did not (p = 0.05). Greater physical activity was the strongest predictor of grip and pinch strength (p < 0.0001). Results indicate that transition through menopause is associated with a decline in grip and pinch strength.

    View details for DOI 10.1093/aje/kwh244

    View details for Web of Science ID 000223791900010

    View details for PubMedID 15321846

  • The social structure, stress, and women's health CLINICAL OBSTETRICS AND GYNECOLOGY Williams, K., Kurina, L. M. 2002; 45 (4): 1099-1118

    View details for Web of Science ID 000179556900015

    View details for PubMedID 12438888

  • Appendicectomy, tonsillectomy, and inflammatory bowel disease: a case-control record linkage study 1st Meeting of the International-Society-for-Equity-in-Health Kurina, L. M., Goldacre, M. J., Yeates, D., Seagroatt, V. BMJ PUBLISHING GROUP. 2002: 551–54


    To determine whether appendicectomy and tonsillectomy are associated with ulcerative colitis (UC) or Crohn's disease (CD); and, if so, whether the associations are related to age at operation.Nested case-control studies using a longitudinal database of linked hospital and death record abstracts.Southern England.Statistical records of people diagnosed with UC, CD, or a control condition admitted to hospitals in a defined area.Appendicectomy under the age of 20 years was associated with a significantly reduced subsequent risk of UC (relative risk =0.48, 95% confidence interval 0.30 to 0.73). The association appeared strongest for appendicectomy between 10 and 14 years of age (relative risk =0.29, 95% CI 0.09 to 0.68). Appendicectomy at the age of 20 years and over was associated with an increased subsequent risk of CD (relative risk =1.92, 95% CI 1.58 to 2.32), largely confined to those people whose CD was diagnosed within a year of appendicectomy. Appendicectomy under 20 years of age, undertaken five years or more before case or control conditions, was suggestively associated with a reduced risk of CD (relative risk =0.71, 95% CI 0.47 to 1.03). Prior tonsillectomy was not associated with any increase or decrease of risk of either UC or CD.Appendicectomy is associated with a reduced risk of UC; and the association is specific to young age groups when the population risk of appendicitis is itself highest. The increased risk of CD after appendicectomy, at short time intervals between the two, is probably attributable to the misdiagnosis of CD as appendicitis.

    View details for Web of Science ID 000176542100015

    View details for PubMedID 12080166

  • Abortion and breast cancer: a case-control record linkage study JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH Goldacre, M. J., Kurina, L. M., Seagroatt, V., Yeates, D. 2001; 55 (5): 336-337

    View details for Web of Science ID 000168138600014

    View details for PubMedID 11297654