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PubMed2003

A profile of adolescent females with a history of sexual assault in texas: familial environment, risk behaviors, and health status.

STUDY OBJECTIVE: To describe the prevalence and correlates of sexual assault among adolescent females. DESIGN: A cross-sectional study. SETTING: A university family planning clinic in south Texas. PARTICIPANTS: Female adolescents <18 years who initiated care at a university family planning clinic in south Texas between June 28, 1992, and April 28, 1994. The adolescents' lifetime sexual assault experience. MAIN OUTCOME MEASURES: Of the 791 adolescents interviewed, 167 (21%) reported a history of sexual assault. Sexual assault was found to be highly associated with multiple risky behaviors and depressive symptoms. Among assaulted adolescents, nonsexual risk behaviors (e.g., substance use) were more common among those who also experienced physical assault than among those who did not. Sexual risk behaviors (e.g., earlier age at sexual debut) and related gynecological infections (e.g., STDs) were more prevalent among women reporting forced sexual intercourse than in those who reported molestation only. Furthermore, adolescents assaulted by a stranger had participated in the most risky behaviors and reported the worst health status, while those assaulted by a date/acquaintance reported higher rates of inconsistent condom use and gynecological infections but lower rates of substance use and depressive symptoms than those assaulted by a family member. CONCLUSION: A deeper understanding of the links between the characteristics of assault, risk behaviors, and health conditions may provide opportunities to design more individualized interventions.

Adolescent↗
PubMed1998

Evaporative water loss, corporal temperature and the distribution of sympatric fiddler crabs (Uca) from south Texas.

Desiccation and thermal stress are among the primary factors limiting terrestriality in crustaceans. Water loss was estimated as weight change in five sympatric species of Uca from south Texas for periods up to 7 hr in dry air. Simultaneously, corporal temperature was measured with a thermocouple placed under the carapace. To estimate integumental permeability to water, 115 mm2 portions of dorsal carapace were glued to U-shaped tubes containing a crab Ringer's solution. These were exposed to dry air and water permeability was estimated from weight change. In whole-animal studies, most rapid weight loss occurred in the first 5 min of exposure to dry air as the body temperature fell below ambient (25 degrees C) in all species. The three most terrestrial species exhibited significant survival over more aquatic congeners after prolonged desiccation. The greatest rate of water loss was observed in Uca subcylindrica which lost 22.9+/-3.0% body weight. Uca panacea and Uca spinicarpa lost 14.1+/-1.6% and 18.5+/-1.8%, respectively. Based on blood osmolarity changes, Uca longisignalis and Uca rapax were more resistant to water loss than Uca subcylindrica under these conditions. Water loss from sections of the dorsal carapace were highest in Uca spinicarpa (10.4 mg/hr/cm2) and Uca longisignalis (8.9 mg/ hr/cm2). Uca subcylindrica and Uca panacea were intermediate (4.5 and 4.2 mg/hr/cm2) while Uca rapax expressed the lowest value (2.9 mg/hr/cm2). These observations support the notion that water loss can effectively lower body temperature in fiddler crabs. However, an inverse relationship between terrestriality and integumental permeability was not evident in these sympatric congeners. Ultimately a balance between physiological and behavioral mechanisms must be achieved for adaptation to the semi-arid habitats in south Texas.

Animals↗
PubMed2001

Prevalence of overweight in a triethnic pediatric population of San Antonio, Texas.

OBJECTIVES: To investigate the prevalence of overweight among different ethnic and gender groups of children and adolescents in the San Antonio, Texas, area and to compare the prevalence with that of the US national figures. DESIGN: Cross-sectional study SUBJECTS: A total of 7208 schoolchildren in kindergarten through 12th grade. There were 4215 Mexican American (MA) (58.5%), 2040 non-Hispanic white (NHW) (28.3%) and 953 African American (AA) (13.2%) subjects. MEASUREMENTS: Weight, height and skinfold thicknesses. RESULTS: The body mass index (BMI, kg/m2) values of MA boys were almost consistently and significantly (P<0.05) larger than NHW boys and showed a tendency to be larger than AA boys, beginning as early as age 6 and continuing through age 17. Although rarely significant, a similar trend in ethnic difference was also noted for girls, with the smallest BMI seen in NHW girls. The subscapular skinfold thickness (SST) for MA boys and girls was significantly (P<0.05) larger than that for NHW counterparts and showed a tendency to be larger than AA counterparts. No significant ethnic differences were present in the triceps skinfold thickness (TST) for girls, but MA boys' TST were occasionally larger (P<0.05) than other ethnic-gender groups. Girls' TST were frequently larger (P<0.05) than boys for each ethnic groups. Using the population data from the National Health and Nutrition Examination Survey (NHANES) I as reference, the prevalence of overweight (BMI> or =95th percentile) was greater in MA (15-28%) and AA (11-29%) boys and girls than in NHW (7-17%) counterparts. The combined prevalence of overweight and 'at risk of overweight' (BMI>85th percentile) was much larger in MA boys (40-50%), MA girls (34-52%), and AA girls (33-51%) than other subgroups. The onset of overweight is quite early, starting at 5-6 y of age, especially in girls. Compared to the data from national surveys, the prevalence of overweight found in this study is higher than reported nationally. We found a marked increase in the skinfold thickness, especially SST for boys, but the increase is less for girls. CONCLUSIONS: The prevalence of overweight is higher in MA boys and girls and AA girls than other ethnic-gender groups in the San Antonio, Texas, area. The prevalence of childhood overweight in the San Antonio area is higher than national figures. The findings of increasing prevalence and early onset of childhood overweight are concerning, because these are known risk factors for diabetes and diseases of many other organ systems. Measures to prevent, reduce or treat childhood obesity are urgently needed.

Adolescent↗
PubMed2005

The University of Texas at Dallas/Callier Center for Communication Disorders Doctor of Audiology Program.

PURPOSE: The purpose of this article is to describe the history and resources of the doctor of audiology (AuD) program at the University of Texas at Dallas (UTD)/Callier Center for Communication Disorders, as well as to provide an overview of the program. METHOD: Data from 1999, when the AuD program was approved by the Texas Higher Education Coordinating Program, to the present were reviewed. CONCLUSIONS: The UTD/Callier Center AuD program includes more than 40 faculty members, spans 3 campuses, and has 8 research laboratories. Total enrollment is 32 students (8 students are admitted each year for the 4-year program). Students have access to extensive resources and learning opportunities. The clinical and research programs at the UTD/Callier Center are actively involved in providing high-quality, in-depth education to future doctors of audiology.

Audiology↗
PubMed2003

Rates of twinning before and after fortification of foods in the US with folic acid, Texas, 1996 to 1998.

Several investigators have reported a 40% increase in the prevalence of twinning among women who have taken folic acid or multivitamins containing folic acid at the time of conception. Given that infant morbidity and mortality are greatly increased among twins, such a large increase in twinning could have serious implications. We undertook this study to determine if US fortification of enriched cereal-grain products with folic acid was associated with an unexpected increase in the prevalence of twinning in the state of Texas. We examined 1 003 207 deliveries conceived in Texas, between 1 January 1996 and 31 December 1998. We compared the prevalence of twin deliveries conceived before, during and after fortification with folic acid, mandated to begin on 1 January 1998. Comparing pregnancies conceived in 1997 with those conceived in 1996, we observed a 2.4% yearly increase in twinning, 1.024 [0.98, 1.07]. Comparing pregnancies conceived in 1998 with those conceived in 1997, we observed a 4.6% yearly increase in twinning, 1.046 [1.00, 1.09]. These increases were adjusted for maternal age, race, education, parity and season of conception. The size and pattern of these increases are consistent with the ongoing increase in twinning of 1-4% per year which began in the US prior to fortification.

Adolescent↗
PubMed1998

Prenatal smoking cessation counseling by Texas obstetricians.

BACKGROUND: Smoking during pregnancy causes 20 to 30 percent of low birthweight and 10 percent of infant mortality in the United States. Brief counseling can reduce rates of smoking. The study objectives were to describe Texas obstetricians' pregnancy smoking cessation counseling activity and to identify attributes associated with consistent, effective counseling. METHODS: A survey was mailed to a random sample of Texas obstetricians. RESULTS: A response rate of 44 percent (n = 204) was attained. A counseling coverage-effectiveness index was created based on the percentage of smokers counseled and use of specific techniques. Almost all respondents reported asking about smoking; fewer, however, reported counseling smokers. Physicians with low index scores, indicating inconsistent coverage, ineffective counseling, or both were dissatisfied with their current counseling, did not perceive counseling to decrease smoking, were not aware of the risks of smoking, and were unfamiliar with expert reports and recommendations for prenatal care. CONCLUSIONS: Obstetricians who are not reached by expert reports and guidelines from groups outside their specialty or who do not perceive the seriousness of maternal smoking are less likely to counsel consistently and to use the most effective techniques. Continuing medical education at local, state, and national levels should be directed toward increasing knowledge and skills about smoking cessation counseling of pregnant women.

Adult↗
PubMedDate not supplied

Abuse of flunitrazepam (Rohypnol) and other benzodiazepines in Austin and south Texas.

Flunitrazepam (Rohypnol) is a benzodiazepine sedative-hypnotic that has generated significant media attention in the United States because of its abuse and its association with "date rape." A field investigation was conducted in south Texas to ascertain the nature and consequences of the abuse of flunitrazepam. In semistructured interviews, 66 subjects identified as flunitrazepam users were asked about their use of alcohol and other drugs and their sexual behaviors. Many subjects identified the drugs they had used as "roches" and gave descriptions of tablets of other benzodiazepines that were not consistent with flunitrazepam. Almost all subjects used other drugs, primarily alcohol and marijuana. Adverse consequences included amnesia, discoordination, automobile accidents, sexual assault, and respiratory depression or arrest. A significant proportion of the subjects reported that continued use was unappealing to them. The abuse of sedative-hypnotics in southeast Texas involves several benzodiazepines and is not limited to flunitrazepam.

Adolescent↗
PubMedDate not supplied

Gene diversity and estimation of genetic admixture among Mexican-Americans of Starr County, Texas.

The Mexican-Americans of Starr County, Texas, classified by sex and birthplace, were studied to determine the extent of genetic variation and contributions from ancestral populations such as Spanish, Amerindian and West African. Using 21 genetic marker systems, genetic distance and diversity analyses indicate that subpopulations of Mexican-Americans in Starr County are similar, and that more than 99% of the total gene diversity (HT) can be attributed to individual variation within the population. Genetic admixture analysis shows the predominant influence comes from the Spanish, a lesser contribution from Amerindians and a slight one from the West Africans. The contribution of the ancestral population to various subpopulations of the Mexican-Americans of Starr County is similar. The Mexican-Americans of Starr County are similar to the Mexican population from northeastern Mexico. The history of admixture is apparently old enough to have brought the entire Mexican-American gene pool to Hardy-Weinberg equilibrium. There is no non-random association of alleles among the genetic marker systems considered in the present study, in spite of the fact that this population is of admixed origin. These results, in aggregate, suggest genetic homogeneity of the Mexican-Americans of Starr County, Texas, and point towards the utility of this population for genetic and epidemiological studies.

Africa↗
PubMed2003

When are phylogenetic analyses misled by convergence? A case study in Texas cave salamanders.

Convergence, i.e., similarity between organisms that is not the direct result of shared phylogenetic history (and that may instead result from independent adaptations to similar environments), is a fundamental issue that lies at the interface of systematics and evolutionary biology. Although convergence is often cited as an important problem in morphological phylogenetics, there have been few well-documented examples of strongly supported and misleading phylogenetic estimates that result from adaptive convergence in morphology. In this article, we propose criteria that can be used to infer whether or not a phylogenetic analysis has been misled by convergence. We then apply these criteria in a study of central Texas cave salamanders (genus Eurycea). Morphological characters (apparently related to cave-dwelling habitat use) support a clade uniting the species E. rathbuni and E. tridentifera, whereas mitochondrial DNA sequences and allozyme data show that these two species are not closely related. We suggest that a likely explanation for the paucity of examples of strongly misleading morphological convergence is that the conditions under which adaptive convergence is most likely to produce strongly misleading results are limited. Specifically, convergence is most likely to be problematic in groups (such as the central Texas Eurycea) in which most species are morphologically very similar and some of the species have invaded and adapted to a novel selective environment.

Adaptation, Biological↗
PubMed2006

The impact of Roman Catholic moral theology on end-of-life care under the Texas Advance Directives Act.

This essay reviews the Roman Catholic moral tradition surrounding treatments at the end of life together with the challenges presented to that tradition by the Texas Advance Directives Act. The impact on Catholic health care facilities and physicians, and the way in which the moral tradition should be applied under this statute, particularly with reference to the provision dealing with conflicts over end-of-life treatments, will be critically assessed. I will argue, based on the traditional treatment of end-of-life issues, that Catholic physicians and institutions should appeal to the conflict resolution process of the Advance Directives Act only under a limited number of circumstances. The implications, under the Texas statute, of varied interpretations of Pope John Paul II's recent allocution on artificial feeding and hydration in the persistent vegetative state will also be considered.

Advance Directives↗
PubMed2006

Methylphenidate abuse in Texas, 1998-2004.

Methylphenidate is a stimulant used in the treatment of attention deficit hyperactivity disorder in children and is subject to abuse. This study describes the patterns of methylphenidate abuse and drug identification (ID) calls received by several poison control centers in Texas. Cases were calls involving methylphenidate received by Texas poison control centers during 1998-2004. Drug ID and drug abuse calls were assessed by call year and geographic location. Drug abuse calls were then compared to all other human exposure (nonabuse) calls with respect to various factors. Of 6798 calls received involving methylphenidate, 35% were drug IDs and 56% human exposures. Of the human exposures, 9% involved abuse. The number of drug ID calls and drug abuse calls received per year both declined during the first part of 7-yr period but then increased. Male patients accounted for approximately 60% of both drug abuse and nonabuse calls. Adolescent patients comprised 55% of drug abuse calls and children less than 13 yr old comprised 62% of nonabuse calls. Although the majority of both types of human exposures occurred at the patient's own residence, drug abuse calls were more likely than non-abuse calls to involve exposures at school (15% vs. 6%) and public areas (3% vs. 0.4%). While drug abuse calls were less likely than nonabuse calls to present with no clinical effects (29% vs. 52%), they were more likely to show more serious medical outcomes. Methylphenidate abusers are more likely to be adolescents. Methylphenidate abuse as compared to other exposures is more likely to occur outside of the person's home and to involve more serious medical outcomes.

Adolescent↗
PubMed2006

Pattern of sildenafil calls to Texas poison control centers, 1998-2004.

Sildenafil, a popular medication approved for the treatment of erectile dysfunction, is often misused. This study sought to describe the patterns of sildenafil calls to poison control centers in Texas during 1998-2004. Data on all sildenafil calls reported to the Texas Poison Center Network were analyzed. There were 628 sildenafil calls, 36% of which were human exposures and 44% were drug identifications. The number of calls increased during 1998-2003 but leveled off in 2004. The sildenafil exposure was isolated in 70% of the human exposure calls and involved other substances in 30% of the calls. Nonisolated exposures were more likely than isolated exposures to be intentional, involve males, occur in adults, and involve more serious problems as reflected by higher rates of health care facility treatment usage and more severe medical outcomes. The most frequently reported clinical effects were dizziness, tachycardia, erythema, and drowsiness. Most sildenafil calls were for human exposures or drug identification. The characteristics of human exposures such as the exposure reason and medical outcome were dependent on the presence of other substances.

Adolescent↗
PubMed2005

Association between sociodemographic factors and exposures and utilization of poison centers in Texas, 1998-2002.

This study evaluated whether selected sociodemographic factors and exposures may be associated with utilization of poison centers in Texas during 1998-2002. Data were obtained from the six poison centers that service the entire state. Cases were all human exposures where the caller county was known. The utilization rate (calls per 1000 population) was calculated for the entire state and for each county. Counties were then grouped into those with utilization rates lower than the utilization rate for the entire state and those with utilization rates higher than the rate for the entire state. The two groups were then compared with respect to sociodemographic factors derived from the 2000 Census and exposure categories derived from the poison centers. The group of counties with lower utilization rates had a lower population density, higher African-American and Hispanic populations, lower median household incomes, and higher percentage of the population who spoke a language other than English at home and spoke English less than "very well." Gender, age, and education factors were not related to utilization rates, and the most frequently reported exposure categories were similar between counties with lower and higher utilization rates. This information can be used to focus education and prevention efforts at those populations with lower utilization of the Texas Poison Center Network.

Adolescent↗
PubMed2006

Aripiprazole exposures reported to Texas poison control centers during 2002-2004.

Aripiprazole is an oral atypical antipsychotic drug used in the treatment of schizophrenia and potentially other behavior disorders. The purpose of this study was to describe the epidemiology of aripiprazole exposures reported to Texas poison control centers. Human aripiprazole exposures reported to six Texas poison control centers were identified and comparisons were made between isolated and nonisolated cases with respect to various demographic and clinical factors. Of 280 human exposures involving aripiprazole, 35% were isolated and 65% were nonisolated. The patients were female in 52% of isolated and 60% of nonisolated cases. Isolated cases were significantly more likely to involve children < 6 yr of age. Fifty-eight percent of isolated cases were unintentional while 68% of nonisolated cases were intentional. Nonisolated cases were much more likely to already be at or en route to a health care facility when the poison control center was contacted. Of those cases with a known medical outcome, no adverse clinical effect was reported in 52% of isolated cases and 35% of nonisolated cases. The adverse clinical effects associated with isolated aripiprazole exposures were mainly neurological, cardiovascular, and gastrointestinal, with the most frequently reported adverse clinical effect being drowsiness or lethargy. The most commonly reported treatments for isolated aripiprazole exposures were single dose of activated charcoal, cathartic, intravenous fluids, dilution, lavage, and antihistamines. In conclusion, isolated and nonisolated aripiprazole exposures varied with respect to patient age, exposure reason, management site, and clinical outcome.

Adolescent↗
PubMed2006

Jimsonweed (Datura stramonium) exposures in Texas, 1998-2004.

For centuries, jimsonweed, Datura stramonium, was known to produce hallucinogenic effects. Jimsonweed is easily obtained and may be abused by adolescents. This investigation examined the patterns of jimsonweed exposures reported to Texas poison control centers during 1998-2004. A total of 188 reported human exposures were identified. Seventy-six percent of the exposures occurred in June-October. For those cases where the information was known, the majority were male (82%) and age 13-19 yr (72%). Intentional abuse or misuse accounted for 78% of reported exposures. Eighty-two percent of the reported exposures were at, en route to, or referred to health care facilities, and 89% of those cases with a known medical outcome had moderate or major effects. The most frequently reported clinical effects were hallucination, tachycardia, agitation, mydriasis, and confusion; the most frequently reported treatments were intravenous fluids replacement, activated charcoal, cathartic, and benzodiazepines. The pattern of reported jimsonweed exposures in Texas was consistent with previously published literature.

Adolescent↗
PubMed2006

Drug identification calls from law enforcement received by Texas poison control centers, 2002-2004.

Aside from calls involving human exposures to potentially toxic substances, poison control centers handle other types of calls such as drug identifications (drug IDs). A portion of drug ID requests originates from law enforcement. The objective of this study was to describe such drug ID requests from law enforcement received by Texas poison control centers during 2002-2004. These calls were examined with respect to year of call, location of caller, and type of drug. There were in total 26,752 drug ID calls (involving 27,800 individual drug ID requests) from law enforcement, representing 3% of total calls and 16% of all drug ID calls received. The number of drug ID calls received from law enforcement and the proportion of total calls and all drug ID calls these represented increased from 2002 to 2004. A disproportionate number of the drug ID requests originated from eastern-central Texas. The most frequently involved drugs were analgesics (particularly acetaminophen and hydrocodone), sedatives and related drugs (particularly alprazolam), and muscle relaxants (particularly carisoprodol).

Humans↗
PubMed2006

Pattern of thiazolidinedione exposures reported to Texas poison centers during 1998-2004.

Information on the management of potentially adverse exposures to thiazolidinediones, a class of oral antihyperglycemic, is limited. This study examined the distribution of thiazolidinedione exposures reported to Texas poison control centers from 1998 through 2004. There were a total of 581 exposures reported, increasing from 31 in 1998 to 140 in 2004. Of the 286 exposures to thiazolidinediones alone, 60% involved patients age 5 yr or younger and 34% patients age 20 yr or greater. Fifty-four percent of the patients were female. The exposure was unintentional in 94% of the exposures, with therapeutic errors accounting for 26% of the exposures reported. Management of 61% of the exposures occurred on site and 39% at a health care facility. Of those exposures with a final medical outcome, 94% were classified as no effect and no cases with major effects or deaths were reported. An adverse clinical effect was reported for 7% of the exposures, the most frequent of which were hypoglycemia (2%), hyperglycemia (1%), and drowsiness (1%). A treatment was reported for 76% of the exposures. The most frequent treatments were decontamination by being given some sort of food (38%), dilution with substances such as milk (34%), and activated charcoal (20%). In conclusion, this study found that the number of reported potentially adverse thiazolidinedione exposures in Texas increased in recent years. Such exposures generally found few adverse clinical effects and were reversible, although some sort of treatment, particularly decontamination, was administered and a large proportion of exposures were managed at or referred to health care facilities.

Adolescent↗
PubMed2004

Annual pattern of human conception in the State of Texas.

A total of 2,828,068 State of Texas singleton conceptions, estimated from the date of the first day of the last menstrual period, were assessed for annual periodicity by multiple-component (1-yr fundamental plus the 6- and 3-month harmonics) Cosinor analysis. An annual pattern (p < 0.001) of conception was detected with a December peak, end of July-beginning of August trough and modest amplitude (total peak-to-trough variation) equal to 13.3% of the yearly mean. Annual patterns (p < 0.005) of generally comparable peak and trough times were also documented for conceptions categorized by maternal marital status, age, ethnicity, years of education, birthplace, and county (Texas-Mexico border vs. non-border) of residence. The amplitude, a measure of the prominence of the annual pattern, varied by race (two-fold greater for non-Hispanic Blacks and Hispanics than non-Hispanic Whites), age (50-60% greater for the 19-year-old and younger group than the 20-29 and 30-44-year-old groups) and maternal education (two-fold greater for those with 0-8 than 13 or more years of schooling). Annual patterns (p < 0.001) in conceptions, generally with December peak and end of July-beginning of August trough, were also detected for neonatal variables categorized by birth weight, birth order, gestational age, and gender. The amplitude of the annual pattern in conceptions varied directly with gestational age and inversely with birth weight class.

Adult↗