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PubMed1987

Body size, fatness, and leanness of Mexican American children in Brownsville, Texas: changes between 1972 and 1983.

Changes in the height, weight, body mass index, triceps skinfold, and arm and estimated midarm muscle circumferences in lower socioeconomic Mexican American children, 6 through 17 years of age, from Brownsville, Texas, were documented on the basis of surveys done in 1972 and 1983. With the exception of height in youths ages 14-17, all parameters show gains at most ages, and in particular an increase in fatness. Brownsville Mexican American youth are similar in height, weight, and the body mass index to Mexican American youth in other areas of Texas. These trends confirm the large proportion of relatively short but heavy children among Mexican Americans.

Adolescent↗
PubMed1987

Primary liver cancer mortality and incidence in Texas Mexican Americans, 1969-80.

During the years 1969-80, primary liver cancer mortality rates for Mexican American males were 2.2 times higher than for other Whites; Mexican American females had rates 2.8 times higher than other White females. Age-specific mortality rates showed even higher risks for older Mexican Americans exceeding both other White and Black rates three to four-fold. Incidence data for El Paso County (Texas) confirmed the increased risk for Mexican American males (risk ratio = 2.3) and females (risk ratio = 13.7). Cirrhosis mortality was also higher in Texas Mexican Americans but risk ratios were not as large as seen for primary liver cancer.

Adult↗
PubMed2000

Prevalence and risk factors of drug-resistant tuberculosis along the Mexico-Texas border.

OBJECTIVES: This study determined factors associated with drug resistance among 3496 patients with tuberculosis who resided in Texas counties along the Mexican border. METHODS: Univariate and logistic regression analyses were performed to identify risk factors associated with drug resistance. RESULTS: Among patients with a history of previous tuberculosis, being 19 years or younger was the only factor associated with multiple drug resistance. Female sex, being 20 to 39 years of age, and foreign birth were risk factors for resistance among patients with no history of previous tuberculosis. CONCLUSIONS: Factors contributing to drug resistance among Hispanic tuberculosis patients along the Texas-Mexico border may differ from those among other populations in the United States.

Adult↗
PubMed2003

Olanzapine versus risperidone in the treatment of schizophrenia : a comparison of costs among Texas Medicaid recipients.

OBJECTIVE: To examine both schizophrenia-related costs and total (schizophrenia plus non-schizophrenia) healthcare costs among Texas Medicaid recipients who had been diagnosed with a schizophrenic disorder and had been initiated on olanzapine or risperidone. METHODS: Cost data for services and prescription use were retrieved for 2,885 patients with schizophrenia who were initiated on olanzapine or risperidone between 1 January 1997 and 31 August 1998. Each patient was followed for 1 year before and 1 year after initiation of therapy. Multivariate analysis was used to control for a wide range of factors (drug choice, patient demographics, pre-utilisation costs, region, health conditions, and treatment patterns) that may influence schizophrenia-related costs and total healthcare costs. Estimation was conducted via a two-stage instrumental variables model. RESULTS: The mean unadjusted total schizophrenia-related cost per patient per year during the observation period was 4,892 US dollars, and the total unadjusted healthcare cost per patient was 7,101 US dollars. Results revealed significant regional variation in schizophrenia-related and total healthcare costs. Significantly higher total healthcare costs were found for patients with other (nonpsychiatric) diagnoses, such as HIV and diabetes mellitus. Although, on average, patients taking olanzapine stayed on therapy longer than those taking risperidone (248.2 days vs 211.1 days; p < 0.0001), multivariate analysis revealed no significant difference in schizophrenia-related costs between patients who received olanzapine and risperidone (123 US dollars lower with olanzapine; p = 0.6439). However, patients who received olanzapine compared with risperidone had significantly lower total medical costs (693 US dollars lower with olanzapine; p = 0.0311). CONCLUSION: This naturalistic study used data from a Texas Medicaid population to examine the schizophrenia-related costs and total healthcare costs for patients who received olanzapine versus risperidone. Multivariate analysis revealed no significant differences in schizophrenia-related costs for patients receiving olanzapine compared with risperidone, although total medical costs were significantly lower for patients initiated on olanzapine.

Adult↗
PubMed1989

The role of Addington v Texas on involuntary civil commitment.

The United States Supreme Court in 1979 set the standard for involuntary commitment. This decision, styled Addington v Texas, raised the burden of proof required to commit persons from the usual civil burden of proof of "preponderance of the evidence" to "clear and convincing" evidence. There was no reduction in the rates of commitment as a result of the decision. The proportion of patients committed in Texas grew in almost linear fashion during the years 1972-1986. Various economic, sociological, and treatment factors may have more influence on commitment of patients than does a court decision.

Commitment of Persons with Psychiatric Disorders↗
PubMed2000

An outcome survey of psychology residency training program graduates of the University of Texas Houston Medical School.

A survey of 71 graduates of the psychology residency program at The University of Texas Houston Medical School and the Texas Research Institute of Mental Science indicated that two-thirds of the respondents were involved in private practice, conducting primarily individual therapy, with assessment also playing a major role in their practice. Managed care had the effect of placing limits on the numbers of sessions available to patients, reducing income, and increasing paperwork associated with practice. Implications for training during residency are that individual therapy, using focused short-term approaches, and assessment should continue to be the primary clinical experiences for trainees, and that there should also be training in the business aspect of practice, including marketing.

Adult↗
PubMed2004

Combining evidence-based practice with stakeholder consensus to enhance psychosocial rehabilitation services in the Texas benefit design initiative.

This article describes the use of evidence-based practice along with a multi-stakeholder consensus process to design the psychosocial rehabilitation components in a benefit package of publicly funded mental health services in Texas. The Texas Benefit Design initiative demonstrates how the combination of science and consensus can be used as a powerful tool for change. It applies the findings of rigorous research regarding psychosocial rehabilitation service delivery approaches that achieve positive outcomes in real world, community settings. At the same time, it makes use of the unique knowledge and experience that mental health service consumers, providers and other advocates can bring to service system design and planning.

Consensus↗
PubMed1985

Temporal patterns of reported single-vehicle car and truck accidents in Texas, U.S.A. during 1980-1983.

Reported single car and truck accidents due specifically to driver 'fatigue' for the 4-year span of 1980-1983 were analyzed for 24-hr, 7-d and 1-yr patterns. Three types of data were examined: (1) accidents in rural Texas, (2) accidents only in San Antonio, the fourth largest city in Texas and (3) accident ratio (number of accidents per time interval divided by traffic volume for the interval) in this city. A statistically significant seasonal variation of relatively low amplitude with peaks in May and July was detected only for accidents in rural areas. High-amplitude periodicities of 7 d were evident in all the data sets, with a peak on the weekend. A very prominent 24-hr pattern was detected as well, with the acrophase determined by single cosinor around 0300. A slight secondary peak in accidents, around 1500, was evident in the data from the rural areas. This secondary peak represented a 12-hr rhythm in addition to the 24-hr. Overall, features of the temporal patterns in accidents over 24 hr and over the year in urban and rural areas differed only slightly. Accident ratios yielded results similar to accident frequencies. However, with regard to the rural data, the shape of the 24-hr temporal pattern varied with driver age; older drivers exhibited a flatter curve with a more pronounced afternoon rather than early morning (around 0300) peak.

Accidents, Traffic↗
PubMed2005

The impact of cooling ponds in North Central Texas on dairy farm performance.

The objective of this study was to determine whether measurable differences existed between farms with and without cooling ponds. Data from Dairy Herd Improvement records for 1999 through 2002 were obtained on 42 herds located in North Central Texas. Nineteen herds had installed cooling ponds, whereas 23 herds had not. Monthly somatic cell counts for each herd were obtained from the Federal Milk Market Administrator. Data were analyzed using the PROC MIXED regression model of SAS. Within and across herd groups, milk production from June to October was significantly lower compared with milk production for the rest of the year. Although there was numerically higher average milk production per cow per day throughout the year for herds that used cooling ponds, differences between herd groups that used or did not use cooling ponds were significant only for August production. Herds without a cooling pond had 4.8 kg/d per cow lower production in August than in the cool-season months of November to May (26.4 +/- 0.6 vs. 31.2 +/- 0.5 kg/d), whereas the difference in August production was only 2.9 kg/d per cow in herds that used cooling ponds (29.0 +/- 0.7 vs. 31.9 +/- 0.6 kg/d). Differences caused by seasonal use of a cooling pond in culling, days to first service, days open, percentage of estruses observed, and somatic cell counts were not significant. Bulk tank milk samples cultured for 10 different bacteria showed no difference between cooling pond and noncooling pond herds in 2002. Also, there was no difference in incidence of violations from the Texas Department of Health for herds that used or did not use cooling ponds. However, herds with cooling ponds did have a lower percentage of successful breedings, fewer days dry, and a higher percentage of cows in milk compared with dairy herds that used other forms of cooling. Such differences may or may not be attributed to seasonal use of a cooling pond. Therefore, cooling ponds may provide relief from heat stress without adversely affecting most important measures of herd performance.

Animals↗
PubMed2004

Symptoms of adverse health effects among residents from communities surrounding chemical-industrial complexes in southeast Texas.

Beaumont and Port Arthur are cities in southeast Texas with major chemical-industrial complexes. Using a menu-driven computer program and trained interviewers, the authors compared self-reported symptoms of adverse health effects in individuals from these two communities with the reference community of Galveston, Texas. There were no statistical differences between the Beaumont and Port Arthur communities. However, the authors found all categories of self-reported health effects were elevated, with an odds ratio > 3.0, when they compared the combined responses of these two communities with the reference community. Although a survey of self-reported symptoms has limitations, the results of this study show a marked difference in all evaluated categories between the two communities near major chemical-industrial complexes and the reference community. Further studies are warranted to determine possible genetic effects, including a higher risk of cancer in these communities.

Adolescent↗
PubMed2002

Geographic association of Rickettsia felis-infected opossums with human murine typhus, Texas.

Application of molecular diagnostic technology in the past 10 years has resulted in the discovery of several new species of pathogenic rickettsiae, including Rickettsia felis. As more sequence information for rickettsial genes has become available, the data have been used to reclassify rickettsial species and to develop new diagnostic tools for analysis of mixed rickettsial pathogens. R. felis has been associated with opossums and their fleas in Texas and California. Because R. felis can cause human illness, we investigated the distribution dynamics in the murine typhus-endemic areas of these two states. The geographic distribution of R. felis-infected opossum populations in two well-established endemic foci overlaps with that of the reported human cases of murine typhus. Descriptive epidemiologic analysis of 1998 human cases in Corpus Christi, Texas, identified disease patterns consistent with studies done in the 1980s. A close geographic association of seropositive opossums (22% R. felis; 8% R. typhi) with human murine typhus cases was also observed.

Adolescent↗
PubMed2004

Laboratory analysis of tularemia in wild-trapped, commercially traded prairie dogs, Texas, 2002.

Oropharyngeal tularemia was identified as the cause of a die-off in captured wild prairie dogs at a commercial exotic animal facility in Texas. From this point source, Francisella tularensis-infected prairie dogs were traced to animals distributed to the Czech Republic and to a Texas pet shop. F. tularensis culture isolates were recovered tissue specimens from 63 prairie dogs, including one each from the secondary distribution sites. Molecular and biochemical subtyping indicated that all isolates were F. tularensis subsp. holarctica (Type B). Microagglutination assays detected antibodies against F. tularensis, with titers as great as 1:4,096 in some live animals. All seropositive animals remained culture positive, suggesting that prairie dogs may act as chronic carriers of F. tularensis. These findings demonstrate the need for additional studies of tularemia in prairie dogs, given the seriousness of the resulting disease, the fact that prairie dogs are sold commercially as pets, and the risk for pet-to-human transmission.

Animals↗
PubMed2003

Ethnic differences in use of antipsychotic medication among Texas medicaid clients with schizophrenia.

BACKGROUND: Culture and ethnicity have been suggested to influence the presentation of patients with schizophrenia. These factors are thought to affect the diagnoses, courses of treatment, and medical utilization patterns of patients with schizophrenia. Specifically, the differences between whites, African Americans, and Mexican Americans are of particular importance, as these groups comprise the majority of the population in the United States today. The traditional course of treatment for many patients with schizophrenia is the drug haloperidol. However, research has shown that some ethnic groups (African Americans and Mexican Americans) may respond better to atypical drugs, such as olanzapine, but may be less likely to receive these drugs. A better response to the course of treatment results in improved medical utilization patterns. The purpose of this study was to examine if ethnicity helped predict whether Texas Medicaid patients were prescribed haloperidol versus olanzapine when other factors were controlled for. METHOD: The study population consisted of 726 patients whose index drug was haloperidol and 1875 patients whose index drug was olanzapine. Patients had an ICD-9-CM diagnosis of schizophrenia or schizoaffective disorder. Texas medical and prescription claims data were used in a logistic regression analysis to determine significant predictors of the type of antipsychotic (haloperidol vs. olanzapine) patients were prescribed. Variables included in the analysis were ethnicity, gender, age, region, other mental illness comorbidities, and previous utilization of medications and resources. Data were collected from Jan. 1, 1996, to Aug. 31, 1998. RESULTS: The results show that when other demographic and utilization factors were controlled for, African Americans were less likely than whites to receive olanzapine rather than haloperidol. CONCLUSION: Ethnicity is a significant predictor of the type of antipsychotic that is prescribed.

Adult↗
PubMed2006

Implementation of the Texas Medication Algorithm Project patient and family education program.

OBJECTIVE: This article describes the implementation and utilization of the patient and family education program (PFEP) component of the Texas Medication Algorithm Project (TMAP). The extent of participation, types of psychoeducation received, and predictors of receiving at least a minimum level of education are presented. METHOD: TMAP included medication guidelines, a dedicated clinical coordinator, standardized assessments of symptoms and side effects, uniform documentation, and a PFEP. The PFEP includes phased, multimodal, disorder-specific educational materials for patients and families. Participants were adult outpatients of 1 of 7 community mental health centers in Texas that were implementing the TMAP disease management package. Patients had DSM-IV clinical diagnoses of major depressive disorder, with or without psychotic features; bipolar I disorder or schizoaffective disorder, bipolar type; or schizophrenia or schizoaffective disorder. Assessments were administered by independent research coordinators. Study data were collected between March 1998 and March 2000, and patients participated for at least 1 year. RESULTS: Of the 487 participants, nearly all (95.1%) had at least 1 educational encounter, but only 53.6% of participants met criteria for "minimum exposure" to individual education interventions. Furthermore, only 31.0% participated in group education, and 42.5% had a family member involved in at least 1 encounter. Participants with schizophrenia were less involved in the PFEP across multiple indicators of utilization. Diagnosis, intensity of symptoms, age, and receipt of public assistance were related to the likelihood of exposure to minimum levels of individual education. CONCLUSION: Despite adequate resources and infrastructure to provide PFEP, utilization was less than anticipated. Although implementation guidelines were uniform across diagnoses, participants with schizophrenia experienced less exposure to psychoeducation. Recommendations for improving program implementation and modification of materials are discussed.

Adult↗
PubMed1977

Prolonged western equine encephalitis viremia in the Texas tortoise (Gopherus berlandieri).

Subcutaneous inoculation of 34 Texas tortoises (Gopherus berlandieri) with either of two strains of Western Equine Encephalitis (WEE) virus resulted in prolonged viremia of up to 105 days' duration. Peak viremia titers exceeded 10(6) suckling mouse intracranial lethal doses per milliliter. The length of the previremic period, the maximum viremia level attained, and the duration of viremia were markedly affected by environmental temperature. Higher temperatures (30 degrees C) shortened the previremic period and the duration of viremia and elevated the maximum viremia level. Lower temperatures had the opposite effect. Mechanisms are suggested whereby Texas tortoises could serve as an overwintering reservoir for WEE virus at any temperature. Neutralizing antibody was detectable following viremia in only 11 of 16 (69%) of surviving tortoises.

Animals↗
PubMed1990

Genetic analysis of Leishmania mexicana populations from Texas, Latin America, and the Caribbean.

A genetic analysis using enzyme data of 72 Leishmania mexicana isolated from hosts in Texas, Latin America, and the Caribbean is presented. All isolates from each country were combined and considered as local populations. Allomorph (allele determined by electrophoresis) frequencies for 20 enzyme (loci) were calculated and 7 populations (Texas, Mexico, Belize, Guatemala, Ecuador [EC], Venezuela, and the Dominican Republic [DR]) were compared pairwise in the statistic of genetic identity (I) (level of genetic similarity). All populations were found to be genetically similar with a mean I value for all comparisons of 0.890 +/- 0.067. When DR was included as one of the pair compared, I = 0.811 +/- 0.034. Among comparisons that include EC (excluding EC vs. DR), I = 0.875 +/- 0.026. The mean I for the other comparisons was less than 0.9. The data indicate that the DR population is divergent enough from the others that it can be considered at the subspecies/incipient species level of evolutionary divergence; the EC population is, to a lesser extent, distinct from the others, and the other 5 represent geographic populations of 1 widely distributed species. A diagrammatic representation of the allomorphs among the 72 isolates is included. There were some allomorph/geographical (or local) population relationships noted.

Animals↗
PubMed1998

Dengue surveillance in Texas, 1995.

Dengue epidemics have been occurring in the Caribbean and Central and South America, including Mexico. In 1995, the proximity of these epidemics increased the possibility of cases occurring in Texas. In response, medical and community educational materials were distributed and active surveillance for dengue cases was initiated. By the end of the year, sera from more than 360 patients were tested for anti-dengue antibody. Twenty-nine cases were detected statewide; seven cases in southern Texas were locally acquired.

Adolescent↗
PubMed1999

Outbreak of histoplasmosis among cavers attending the National Speleological Society Annual Convention, Texas, 1994.

In June 1994, 18 people developed serologically confirmed histoplasmosis following cave exploration associated with the annual National Speleological Society Convention in Bracketville, Texas. Six others had an undiagnosed illness suspected to be histoplasmosis. Two persons were hospitalized. We conducted a survey of convention attendees and a nested case-control study of those entering caves. We also conducted a histoplasmin skin test survey of a subgroup of the society, the Texas Cavers Association, who were attending a reunion in October 1994. Among the national convention attendees, exposure to two caves was identified as responsible for 22 (92%) of the 24 cases; 12 (75%) of 16 people exploring one cave (Cave A) and 10 (77%) of 13 exploring a separate cave (Cave B) developed acute histoplasmosis. Additional risk-factors included fewer years of caving experience, longer time spent in the caves, and entering a confined crawl space in Cave A. Of 113 participants in the separate skin test survey, 68 (60%) were found to be skin test positive, indicating previous exposure to Histoplasma capsulatum. A positive skin test was significantly associated with male sex and more years of caving experience. Those less experienced in caving associations should be taught about histoplasmosis, and health care providers should pursue histories of cave exposure for patients with bronchitis or pneumonia that does not respond to initial antibiotic therapy.

Adolescent↗