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PubMed2006

Changes in abortions and births and the Texas parental notification law.

BACKGROUND: On January 1, 2000, Texas began enforcement of a law that requires physicians to notify a parent of a minor child seeking an abortion at least 48 hours before the procedure. METHODS: We assessed changes in the rates in Texas of abortions and births (events per 1000 age-specific population) before enforcement of the parental notification law (1998 to 1999) and after enforcement (2000 to 2002). We did this by comparing the rate changes among minors 15 to 17 years of age at the time of conception (i.e., those who were subject to the law) with those of teens 18 years of age at the time of conception (i.e., those who were not subject to the law). RESULTS: After enforcement of the law, abortion rates fell by 11 percent among 15-year-olds (rate ratio, 0.89; 95 percent confidence interval, 0.83 to 0.94), 20 percent among 16-year-olds (rate ratio, 0.80; 95 percent confidence interval, 0.76 to 0.85), and 16 percent among 17-year-olds (rate ratio 0.84; 95 percent confidence interval, 0.80 to 0.87), relative to the rates among 18-year-olds. Among the subgroup of minors 17.50 to 17.74 years of age at the time of conception (who would have been subject to the parental notification law in early pregnancy), birth rates rose by 4 percent relative to those of teens 18.00 to 18.24 years of age (rate ratio, 1.04; 95 percent confidence interval, 1.00 to 1.08). The adjusted odds ratio for having an abortion after 12 weeks' gestation among minors 17.50 to 17.74 years of age as compared with 18-year-olds was 1.34 (95 percent confidence interval, 1.10 to 1.62). CONCLUSIONS: The Texas parental notification law was associated with a decline in abortion rates among minors from 15 to 17 years of age. It was also associated with increased birth rates and rates of abortion during the second trimester among a subgroup of minors who were 17.50 to 17.74 years of age at the time of conception.

Abortion, Legal↗
PubMed2002

Cutaneous leishmaniasis: Texas case diagnosed by electron microscopy.

A 78-year-old woman from south-central Texas without a history of travel outside the state presented with an erythematous papule on her right forearm. A biopsy specimen showed non-necrotizing granulomatous inflammation with negative stains for organisms. The lesion was recalcitrant to treatment with topical steroids, and a second biopsy specimen, obtained 3 months later, showed a histiocytic infiltrate in the upper dermis. Numerous, round, 1- to 30-microm bodies were seen within vacuoles in the histiocyte's cytoplasm. Giemsa, Grocott-Gomori methenamine-silver nitrate, and periodic acid-Schiff stains were negative. Electron microscopic examination of the paraffin-embedded tissue showed parasites diagnostic of leishmaniasis. On review of the literature, we found that 29 other cases of autochthonous cutaneous leishmaniasis have been reported in Texas. We emphasize the endemic nature of this condition in Texas.

Aged↗
PubMed1986

Mitochondrial DNA analysis of hybridization between sympatric white-tailed deer and mule deer in west Texas.

Sympatric populations of white-tailed deer and mule deer (Odocoileus virginianus and Odocoileus hemionus, respectively) on a west Texas ranch share a common mitochondrial DNA restriction map genotype. Phylogenetic analysis indicates that this genotype is more characteristic of O. virginianus than of O. hemionus. The genotype of west Texas deer differs from that of O. virginianus from South Carolina by five mutational events (1.3% sequence divergence), whereas it differs from that of O. hemionus from California by 17 events (5.5% divergence). We suggest that interspecies hybridization has occurred, primarily between mule deer bucks and white-tailed deer does, with preferential absorption of hybrid offspring into the mule deer gene pool. Introgressive hybridization may be involved in ongoing displacement of mule deer by white-tailed deer in west Texas.

Animals↗
PubMed2005

Regional variation and relationships between the contaminants dde and selenium and stable isotopes in swallows nesting along the Rio Grande and one reference site, Texas, USA.

Cave swallows (Petrochelidon fulva) and cliff swallows (P. pyrrhonota) nest in numerous colonies throughout the Texas portion of the Rio Grande along the U.S. border with Mexico. We collected swallows during 1999 and 2000 from eight locations along the Rio Grande to determine if delta15N and delta13C values could be used to predict 1,1-di-(p-chlorophenyl-)2,2-dichloroethene (DDE) and selenium (Se) contaminant burdens in insectivorous birds nesting across a geographic gradient in the Texas-Mexico border and to discern if stable isotopes could help discriminate between local versus nonlocal acquisition of contaminants. We analysed delta15N and delta13C in liver and muscle and DDE and Se in swallow carcasses. Within individuals, delta15N was higher in liver than in muscle of both species by an average of 1.34%, whereas delta13C was 0.145% higher in muscle than in liver. Significant differences occurred among locations in delta15N and delta13C values in liver and muscle of both species. Cave swallows from three locations in the Lower Rio Grande Valley were more enriched in delta15N than swallows from other sites. In general, swallows nesting in more northern latitudes along the Rio Grande had lower delta15N and delta13C values than those nesting farther south. Concentrations of DDE were significantly greater in swallows from El Paso, Llano Grande, and Pharr than in those from Brownsville, Falcon Lake, Laredo, Del Rio, and a reference site outside the Rio Grande. All swallows (n = 21) from El Paso, Llano Grande, and Pharr had DDE concentrations > or = 3 microg g(-1) wet weight (ww), a value three times greater than the estimated threshold in avian prey that could cause potential reproductive failures in raptors. Concentrations of Se also were significantly greater in El Paso and Del Rio than at other locations. Most Se concentrations were not of concern for direct effects on birds or their predators. Principal component analysis indicated some positive correlations between delta15N and delta13C values in tissues and contaminant concentrations in carcass; however, analysis of covariance suggested a stronger effect of location on concentrations of DDE and Se. At the local level (Llano Grande and Pharr) there was a significant positive correlation between delta15N in liver and DDE concentrations in swallow carcasses; however, Se concentrations were not significantly correlated with isotopes even at the local level. Our results provide a good database of delta15N and delta13C values for insectivorous birds nesting along the Rio Grande. Similar ecologies for cave and cliff swallows and their abundance and wide distribution along the Rio Grande make them ideal indicators of environmental pollution of this portion of the Texas-Mexico border.

Animals↗
PubMed2006

Valdecoxib exposures reported to Texas poison centers during 2002-2004.

Valdecoxib is a drug possessing anti-inflammatory and analgesic properties and acts by binding to cyclo-oxygenase-2. The objective of this study was to describe the epidemiology of valdecoxib exposures reported to Texas poison centers. Human valdecoxib exposures reported to six Texas poison centers were identified and comparisons were made between isolated and nonisolated cases with respect to various demographic and clinical factors. Of 328 human valdecoxib calls, 55% were isolated and 45% were nonisolated. Fifty-eight percent of isolated cases involved female patients while 69% of nonisolated cases involved females. Fifty-three percent of isolated cases involved patients of age less than 6 yr, whereas 71% of nonisolated cases involved patients age 20 yr or greater. Eighty-four percent of isolated cases were unintentional and 67% of nonisolated cases were intentional. The patient was managed outside of health care facilities in 84% of isolated cases and 26% of nonisolated cases. Of those cases with a known medical outcome, 92% of isolated cases had no effect and 35% of nonisolated cases had no effect. Among isolated valdecoxib exposures, no particular clinical effect was reported in more than five cases. Isolated and nonisolated valdecoxib exposures varied with respect to patient gender and age, exposure reason, and clinical outcome. Adverse effects for isolated valdecoxib exposure involved only a small portion of patients that reported to the Texas poison control centers.

Adolescent↗
PubMed2001

Deaths related to the inhalation of volatile substances in Texas: 1988-1998.

Analysis of death certificates in Texas from 1988 to 1998 showed that the characteristics of 144 Texans for whom inhalants were mentioned as a contributing cause of death are different from those Texans who report use of inhalants in surveys and from persons who died from inhalant abuse in Virginia. While Texas surveys show little difference in prevalence of use between white and Hispanic adolescents or between boys and girls, Texas death data indicate inhalant use is also a problem among adult white males. The mean age of decedents was 25.6 years (SD 9.8 years), and ages ranged from 8 to 62 years. There were 92% males, 81% whites, and 17% Hispanics. Of the death certificates, 35% mentioned Freon, and 25% mentioned chlorinated hydrocarbons. Of those with the mention of Freon, 42% were students (mean age 16.4 years), and 37% were mechanics, installers, and repairers (mean age 27.4 years), occupations in which Freon can be readily available. Of the chlorinated hydrocarbon deaths, 49% were students (mean age 17.5 years), and 51% were from other occupations (mean age 27.4 years). Research on drug use and the workplace is not extensive, and the effects of inhalant intoxication can be a serious problem in the workplace. Prevention campaigns need to inform the public that inhalant abuse is not just a problem among youngsters, and intervention services for adult abusers should be provided within the context of employee assistance programs.

Administration, Inhalation↗
PubMed1999

A retrospective analysis of 96 "asp" (Megalopyge opercularis) envenomations in Central Texas during 1996.

BACKGROUND: The most frequently reported caterpillar envenomation in Central Texas is by the puss caterpillar or "asp," Megalopyge opercularis. This caterpillar is described by patients and physicians as inflicting intense radiating pain. The intensity of symptoms may be underestimated leading to undertreatment. Adequate treatment protocols have been lacking and those in use are not very successful. We present a retrospective study of patients who were stung and contacted the Central Texas Poison Center. METHODS: All human exposures to asp stings reported to the Central Texas Poison Center during 1996 were included. Inclusion criteria consisted of all cases documented as an asp envenomation by the specialists in poison information. Characterization of symptoms and treatment used were evaluated. RESULTS: There were 96 exposures to asps reported. Ninety-five of the patients experienced local pain with 26 of these reporting intense radiating pain. Forty developed erythema, 27 described edema, and 9 complained of welts/hives. Other symptoms reported included white spots (4), pruritus (3), red streak (2), numbness (2), and individual accounts of chest pain, rash, ecchymosis, tingling, blister, and muscle spasm. There was no treatment modality that promptly relieved pain. DISCUSSION: Although asp envenomations appear to be very common, clinical cases have rarely been documented. This may be due to physicians not recognizing the etiological agent. Pain may be very intense and standard pain management appears to be unsuccessful. CONCLUSION: This study suggests that further examination of treatment modalities may be beneficial in addressing the morbidity of Megalopyge opercularis envenomations.

Animals↗
PubMed2001

Analysis of pesticide runoff from mid-Texas estuaries and risk assessment implications for marine phytoplankton.

During 1993, estuarine surface water samples were collected from the mid-Texas coast (Corpus Christi to Port Lavaca, TX). Agricultural watershed areas as well as tidal creeks immediately downstream were chosen as sampling sites along with adjoining bay sampling stations. Collections were made throughout the growing season (February to October 1993) before and after periods of significant (> 1.25 cm) rainfall. All samples were initially screened for the presence of pesticides using enzyme-linked immunosorbent assay (ELISA) test kits (EnviroGard) for triazine herbicides and carbamate insecticides. All samples were extracted and then analyzed using gas chromatography (GC) for quantification of atrazine. Only samples testing positive for carbamate insecticides via ELISA were further extracted for GC analysis to quantify aldicarb and carbofuran. Additionally, laboratory toxicity tests using phytoplankton were examined from published, peer-reviewed literature and compared with the atrazine field levels found in Texas. Results of ELISA screening indicated the presence of triazine herbicides in nearly all samples (>93%). GC analysis further confirmed the presence of atrazine concentrations ranging from <0.01-62.5 microg/L. Screening tests also found detectable levels of carbamate insecticides (aldicarb and carbofuran) that were also confirmed and quantified by GC. Comparison of measured concentrations of atrazine compared with published toxicity tests results indicated that there was a potential environmental risk for marine/estuarine phytoplankton in surface waters of Texas estuaries, particularly when the chronic nature of atrazine exposure is considered.

Atrazine↗
PubMed2003

Cancer mortality in a Texas county with prior uranium mining and milling activities, 1950-2001.

Uranium was discovered in Karnes County, Texas, in 1954 and the first uranium mill began operating in 1961 near Falls City. Uranium milling and surface and in situ mining continued in Karnes County until the early 1990s. Remediation of uranium tailings ponds was completed in the 1990s. There were three mills and over 40 mines operating in Karnes County over these years and potential exposure to the population was from possible environmental releases into the air and ground water. From time to time concerns have been raised in Karnes County about potential increased cancer risk from these uranium mining and milling activities. To evaluate the possibility of increased cancer deaths associated with these uranium operations, a mortality survey was conducted. The numbers and rates of cancer deaths were determined for Karnes County and for comparison for four 'control' counties in the same region with similar age, race, urbanisation and socioeconomic distributions reported in the 1990 US Census. Comparisons were also made with US and Texas general population rates. Following similar methods to those used by the National Cancer Institute, standardised mortality ratios (SMRs) were computed as the ratio of observed numbers of cancers in the study and control counties compared to the expected number derived from general population rates for the United States. Relative risks (RRs) were computed as the ratios of the SMRs for the study and the control counties. Overall, 1223 cancer deaths occurred in the population residing in Karnes County from 1950 to 2001 compared with 1392 expected based on general population rates for the US. There were 3857 cancer deaths in the four control counties during the same 52 year period compared with 4389 expected. There was no difference between the total cancer mortality rates in Karnes County and those in the control counties (RR = 1.0; 95% confidence interval 0.9-1.1). There were no significant increases in Karnes County for any cancer when comparisons were made with either the US population, the State of Texas or the control counties. In particular, deaths due to cancers of the lung, bone, liver and kidney were not more frequent in Karnes County than in the control counties. These are the cancers of a priori interest given that uranium might be expected to concentrate more in these tissues than in others. Further, any radium intake would deposit primarily in the bone and radon progeny primarily in the lung. Deaths from all cancers combined also were not increased in Karnes County and the RRs of cancer mortality in Karnes County before and in the early years of operations (1950-64), shortly after the uranium activities began (1965-79) and in two later time periods (1980-89, 1990-2001) were similar, 1.0, 0.9, 1.1 and 1.0, respectively. No unusual patterns of cancer mortality could be seen in Karnes County over a period of 50 years, suggesting that the uranium mining and milling operations had not increased cancer rates among residents.

Death Certificates↗
PubMed2005

Evaluation of the Texas 0.08 BAC law.

AIMS: The purpose of the present study was to assess the effects on alcohol-involved traffic crashes and fatalities of the 0.08 blood alcohol concentration (BAC) per se law introduced in the state of Texas in 1999. METHOD: Data pertaining to alcohol-involved traffic crashes and fatalities were extracted from two datasets: the Fatality Analysis Reporting System (FARS) compiled by the National Highway Traffic Safety Administration (for the period January 1995-September 2002), and the Texas Department of Public Safety (DPS) reports of Alcohol Related Motor Vehicle Traffic Accidents and Casualties (for the period January 1995-December 2000). The data were analysed using time-series methods (ARIMA routines). The effects of the law on all drivers were assessed, along with the effects among gender, racial, and age subgroups and crash location (urban vs rural). RESULTS: Separate time-series analyses were conducted with all alcohol-involved and fatal alcohol-involved crashes from the DPS dataset and fatal alcohol-involved crashes from the FARS dataset as the outcome variables. None of the effects for either the total sample or any of the subgroups analysed was statistically significant (this was true of both the FARS and DPS datasets). CONCLUSIONS: While there is a growing body of evidence that indicates that 0.08 BAC laws can be effective in reducing alcohol-involved traffic accidents and fatalities, the present study shows that this was not the case in Texas. Future research should move beyond the simple question of whether or not 0.08 BAC laws 'work' and instead explore in more detail the conditions, such as publicity and enforcement, under which the law does or does not contribute to a decline in alcohol-involved accidents and fatalities.

Accidents, Traffic↗
PubMed1989

Heterogeneity among isolates of rapidly growing mycobacteria responsible for infections following augmentation mammaplasty despite case clustering in Texas and other southern coastal states.

Thirty-seven cases of rapidly growing mycobacterial wound infections following augmentation mammaplasty were identified between 1979 and 1988. The infections were usually unilateral and had a narrow geographic distribution: almost 60% were from Texas and 92% from five southern coastal states. In Texas a seasonal incidence was observed; 45% of all previously reported and current patients had undergone mammaplasty in April, May, or June. Although these findings suggested a possible common source, analysis of 35 available isolates revealed 19 different phenotype patterns. Five different taxonomic groups were represented, although most isolates (70%) were Mycobacterium fortuitum biovar fortuitum. Plasmid bands were identified in 10 of 15 strains studied, with nine different profiles. An additional 11 cases of breast infection due to rapidly growing mycobacteria not associated with augmentation were also identified, of which nine came from the same states that contributed mammaplasty cases. Rapidly growing mycobacterial infections of the breast are endemic in Texas and other southern coastal states, and the heterogeneity of the isolates suggests that most cases are unrelated.

Adult↗
PubMed1991

Distribution and density of polygyne fire ants (Hymenoptera: Formicidae) in Texas.

Multiple-queen or "polygyne" Solenopsis invicta Buren colonies are a serious economic and environmental concern because they occur in much higher densities than the monogyne form. Polygyne colonies have been found at numerous locations in the United States; nevertheless, the frequency and distribution of this form are poorly known. Almost 700 roadside sites in 168 Texas counties were surveyed. Polygyny was discovered at 54% of the infested sites. Polygyne populations were scattered in a mosaic across Texas. The frequency of polygyny varied somewhat with geographic region, but the pattern was generally unrelated to habitat and environmental conditions. Polygyne sites averaged more than twice as many mounds per hectare as monogyne sites. Populations of monogyne and polygyne forms were slightly lower in cooler and drier portions of the state. Mounds of both forms were about the same size. Polygyny was correlated with lower rates of sexual production and reduced numbers of native ants. The high frequency of polygyny in Texas indicates that the fire ant problem in the state is much greater than previously realized.

Analysis of Variance↗
PubMed2003

Resistance to the Mexican rice borer (Lepidoptera: Crambidae) among Louisiana and Texas sugarcane cultivars.

A 2-yr study to evaluate Louisiana and Texas sugarcane, Saccharum spp., cultivars for resistance to the Mexican rice borer, Eoreuma loftini (Dyar) was conducted in two locations in Texas, chosen for having different infestation levels. Criteria for assessment of resistance included percentage of bored internodes and adult emergence holes, the latter used to determine the relative impact of each cultivar on the potential areawide buildup or reduction of adult E. loftini populations. A recently released cultivar, HoCP 85-845, seemed to lose a portion of its resistance under heavy E. loftini infestation pressure, suggesting its value only in moderate-to-low infestation conditions. Cultivar CP 70-321 was the most resistant. Results indicated that cultivar LCP 85-384 was significantly (P < 0.05) more susceptible than NCo 310, traditionally the most susceptible cultivar commercially produced in Texas. In 2001, LCP 85-384, which now represents 85% of the production area in Louisiana, had the greatest moth production per hectare (17,052 +/- 3,956) under the lower infestation pressure, significantly (P < 0.05) higher than HoCP 85-845 (3,038 +/- 2,353). In a portion of the test at the high-infestation location, high levels of sodium and magnesium salt stress (15-30-cm soil depth) were associated with higher E. loftini damage in all cultivars except HoCP 91-555 and CP 70-321.

Animals↗
PubMed1988

The epidemiology of Rocky Mountain spotted fever in Arkansas, Oklahoma, and Texas, 1981 through 1985.

From 1981 through 1985, a total of 851 laboratory-confirmed cases of Rocky Mountain spotted fever were reported in Arkansas, Oklahoma, and Texas. Annual incidence rates in each state increased from 1981 through 1983, ranging from a 17% increase in Arkansas to a 137% increase in Texas. In the period 1984 through 1985, the annual incidence rates in each state decreased over 50%. A total of 519 cases were males. A majority of cases (51%) were 19 years of age or younger. April through August were the months of onset of symptoms for 83% of the cases. Differences in distribution of month of onset of symptoms were noted when comparing age groups and state of residence of the cases. The case-fatality ratio was 4.7%. Case-fatality ratios were higher in blacks and in older age groups. An endemic focus of Rocky Mountain spotted fever exists in Arkansas, Oklahoma, and Texas. The annual incidence trend for spotted fever in these three states is dissimilar to the trends in other states.

Adolescent↗
PubMedDate not supplied

Genetics of house flies. Variability studies with North Dakota, Texas, and Florida populations.

Genetic data were used to compare the structure of native house fly populations collected in North Dakota, Texas, and Florida. Recombination studies with mutant markers on chromosomes 3 and 4 indicated a lack of inversion polymorphism among the three populations in those areas of the genetic map studied. Significant differences were observed among flies from the three regions with regard to the frequency of 1) females that produced only male progeny, and 2) male-determining 3rd chromosomes (IIIm chromosomes). However, the North Dakota and Texas flies were more similar to each other than to the Florida flies since populations from the two former areas possessed a low frequency of both male-producing females and IIIm chromosomes; in contrast, the Florida population was void of females that produced males only and a high percentage if not all Florida males appeared to possess the IIIm male-determining mechanism. Tests for recessive lethal 3rd chromosomes showed that there was no significant difference in the frequency of lethal factors recovered from the North Dakota and Texas flies; the presence of IIIm chromosomes in Florida males precluded the recovery of lethal factors from this population by the method employed. The data suggest that house fly strains to be employed in genetic control programs should 1) originate from target control areas to avoid possible behavioral differences existing among flies from different locales, 2) be initiated with as many flies as possible to provide a background for the maintenance of variability, and 3) be renewed periodically with field-collected material since the genotype may be capable of rapid reorganization in response to laboratory selection pressures.

Animals↗
PubMed1989

Practice locations of Texas family practice residency graduates, 1979-1987.

The location of a physician's residency training is known to be a factor in selection of a practice location. In this paper, the authors analyze the practice locations of 689 family physicians who graduated from residency programs in Texas between 1979 and 1987 and who were practicing in Texas in 1988. One-third of these graduates were practicing in cities the same size as their residency program city. More than half were in counties located within 60 miles of the residency city. Both of these trends can be explained to a large degree by the fact that a high percentage of graduates remained in their residency city to practice. When these nonmobile graduates are removed from the sample, the findings show no correlation between the size of the residency city and the size of the practice city. More than two-thirds of those graduates who left their residency city were in counties beyond a 60-mile radius. Almost two-thirds were practicing in communities of less than 25,000 population. The authors conclude that state support for family practice residency training has been effective in distributing family physicians in a manner that addresses the needs of the state of Texas as a whole.

Family Practice↗
PubMed1999

The InterCon network: a program for education partnerships at the University of Texas-Houston Health Science Center.

The University of Texas-Houston Health Science Center (UT-Houston) has created programs and activities to address the state's pressing needs in minority education. Through InterCon, a network of universities and K-12 schools, UT-Houston works with its partners to identify competitive candidates in the current pool of minority graduates with bachelor's degrees and to help them--along with their non-minority counterparts--progress in their education. Another objective is to expand the pool of minorities underrepresented in medicine who complete high school and go to college. In 1994 UT-Houston and Prairie View A&M University created a collaborative venture to provide new educational opportunities at UT-Houston for Prairie View's predominantly African American students. A three-track summer internship program--a result of that collaboration--has since been expanded to partnerships with other minority and majority universities throughout Texas. In 1998, for example, 108 undergraduate students from these universities (and 40 other universities nationwide) participated in research, professional, and administrative summer internships at UT-Houston. The InterCon network also has partnerships with K-12 schools. UT-Houston works with inner-city, suburban, and rural school districts to develop education models that can be transferred throughout the state. The partnerships deal with helping to teach basic academic skills and computer literacy, improve science-related instruction, meet demands for health promotion materials and information for school-initiated health and wellness programs, and develop distance-learning paradigms. UT-Houston views InterCon as a program helping Texas institutions to engage and adapt to the socioeconomic factors, demographic changes, and technology explosion that currently challenge public education.

Community-Institutional Relations↗
PubMed2004

Evaluating the Texas Statewide Family Practice Preceptorship Program, 1992-2000.

PURPOSE: Since 1979, the Texas Statewide Family Practice Preceptorship Program (TSFPPP) has conducted ambulatory preceptorships to increase the number of medical students selecting family practice residencies. The authors describe the evaluation of the TSFPPP's efficacy in terms of four evaluation questions and outcome measures identified by program users from eight Texas medical schools. METHOD: The authors compared the proportion of 10,081 Texas medical school students graduating from 1992-2000 who chose family practice or other primary care residencies following participation or nonparticipation in the TSFPPP's preclinical and clinical programs. RESULTS: The proportion of students choosing family practice residencies among TSFPPP participants was significantly greater than among nonparticipants. Participation in the TSFPPP was associated with an increased choice of a family practice residency for students who were involved in the TSFPPP at the preclinical level (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.41-1.87); the clinical level (OR, 2.31; 95% CI, 1.99-2.68); and both levels (OR, 4.98; 95% CI, 3.75-6.68) compared to non-TSFPPP participation. There was a 44% increase in preceptors willing to teach medical students. CONCLUSIONS: Participation in the TSFPPP is associated with a greater likelihood of students selecting a family practice residency. The interinstitutional approach to analyzing effects of the preceptorship on students' specialty choices focuses attention on primary care issues that, in the long run, may affect an entire state's health care delivery system.

Adult↗