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PubMed2006

Evaluation of short-term Ogawa passive, photolytic, and federal reference method sampling devices for nitrogen oxides in El Paso and Houston, Texas.

Passive Sampling Devices (PSDs) have been successfully used by government and academic agencies to monitor common ambient air pollutants such as ozone and nitrogen dioxide (NO(2)). Most PSD studies have involved long-term (e.g. bi-weekly or monthly) sampling. But the Passive Ozone Network of Dallas (POND) studies of 1998 and 1999 showed that high quality 24-hour and 12-hour data using the Ogawa PSD could be collected for ambient ozone concentrations. This paper presents an evaluation of short-term passive sampling results for nitrogen oxides (NO(x)) in El Paso and Houston, Texas, using the Ogawa PSD. The Ogawa NO(x) PSDs were compared to both Federal Reference Method (FRM) monitors and a photolytic converter, with the photolytic converter designed to report closer concentrations to "true" NO(x) by more effectively limiting the interferences of other nitrogen species. Overall, good agreement was noted for all three monitor types in both cities, supporting the potential use of lower cost Ogawa PSDs for large multi-site episodic NO(x)/NO(2)/NO saturation screening studies. This evaluation was conducted during two separate six week periods of the cooler winter months so additional testing of the Ogawa PSDs during different seasons is recommended.

Air Movements↗
PubMed1997

Molecular markers reveal differentiation among isolates of Coccidioides immitis from California, Arizona and Texas.

Coccidioides immitis causes coccidioidomycosis, a fungal disease of both immuno-compromised and otherwise healthy people; it is capable of causing large epidemics and the disease is often refractory to chemotherapy. To quantify the magnitude of population differentiation and estimate levels of gene flow in C. immitis, multilocus genotypes were scored for 20-25 clinical isolates from each of Bakersfield (California), Tucson (Arizona), and San Antonio (Texas). The molecular markers used were PCR products with polymorphic restriction endonuclease sites, found and characterized in a previous study of the Tucson population. The data show very highly significant differences in allele frequencies between all three populations, and suggest very low levels of migration between populations. One isolate in the San Antonio sample was an outlier, showing the California-specific allele at all four of the loci distinguishing the two populations, and subsequent inquiries indicated that the infection had indeed been acquired in California. Thus, genetic information can be used to infer the geographical origin of a fungal infection.

Arizona↗
PubMed2002

Renal rehabilitation and improved patient outcomes in Texas dialysis facilities.

BACKGROUND: Because a cure is not a reasonable goal for patients with end-stage renal disease (ESRD), optimal physical and mental health functioning are primary objectives of care and major determinants of health-related quality of life, morbidity, and mortality. This cross-sectional study used facility-level survey data to test the hypothesis that dialysis unit rehabilitation activities are associated with higher patient functional status. METHODS: Data were collected from 169 dialysis facilities in the ESRD Network of Texas (Network 14), including facility characteristics, facility-level patient demographic and clinical characteristics, and facility rehabilitation activities measured by the Life Options Unit Self-Assessment Tool (USAT). Facility-level data on patient functioning and well-being measured by the Medical Outcomes Study 36-Item Short-Form Health Survey were obtained from all 86 of the respondent facilities that collected it. RESULTS: Most participating facilities reported performing rehabilitation activities in all five categories (encouragement, education, exercise, employment, and evaluation). The median number reported was 32 of a possible 100 activities. Exercise interventions were the least often implemented activities. Linear multiple regression showed that facility rehabilitation activity scores measured by the USAT were associated with higher facility mean Mental Component Scale (MCS) scores, controlling for facility characteristics (size, profit status), facility-level patient demographic characteristics (diabetes, race, sex, age), and facility-level patient laboratory variables: urea reduction ratio and hemoglobin and serum albumin levels. CONCLUSION: Because MCS scores have been shown in other studies to be inversely related to morbidity and mortality, this finding suggests that the introduction of rehabilitation interventions into the dialysis care regimen may prove beneficial.

Female↗
PubMed2000

No evidence of linkage to chromosome 1q42.2-43 in 131 prostate cancer families from the ACTANE consortium. Anglo, Canada, Texas, Australia, Norway, EU Biomed.

Genetic linkage studies worldwide have proposed various chromosomal localizations for prostate cancer susceptibility genes. A recent study found evidence for linkage to chromosome 1q42.2-43. The aim of our study was to attempt to confirm these findings by performing linkage analysis in 131 families with multiple prostate cancer cases selected from the ACTANE (Anglo, Canada, Texas, Australia, Norway, EU Biomed) Consortium. Parametric and non-parametric linkage (NPL) analyses were performed. Two-point LOD scores failed to show evidence of linkage at any marker (maximum two-point LOD score = 0. 40 at recombination fraction theta = 0.2 with marker D1S2850). Using a multipoint heterogeneity analysis, the estimated proportion of families linked to this putative locus (alpha) was 0% (95% CI = 0. 00-0.33). Non-parametric linkage analysis also found no evidence of linkage (maximum NPL score = -0.12, P = 0.55). This analysis of 131 ACTANE families does not support the presence of a locus for a prostate cancer susceptibility gene at 1q42.2-43. Although we cannot rule out the existence of such a locus, analysis indicates that less than 16% of families could be linked to this region. These findings may be a reflection of the locus heterogeneity involved in this disease indicating that there are still other major susceptibility loci to be identified.

Aged↗
PubMed2001

Livestock trauma in central Texas: cowboys, ranchers, and dudes.

INTRODUCTION: Emergency nurses routinely treat a wide variety of animal-related injuries, yet the trauma literature rarely addresses injuries associated with livestock. METHODS: The purpose of this retrospective, descriptive study was to examine the incidence, demographics, severity, and other factors associated with trauma related to livestock in persons admitted to one central texas trauma center during a 5-year period. Patients were classified by activity at the time of injury. The following 5 categories were identified: cowboy, rancher, dude, standing near, and unidentified. Groups were further analyzed by the type of animal involved in the injury, mechanism of injury, patient sex and age, body regions injured, indicators of severity, and county in which the injury occurred. RESULTS: One hundred thirty-six patients met the inclusion criteria. Of these patients, 24% were categorized as cowboys, 18% as ranchers, and 39% as dudes. Six percent were standing near the animal, and activity at the time of injury could not be adequately determined for 13% of patients. Typical demographics, mechanisms of injury, wounds, indicators of severity, and animals were found to be associated with each activity class. DISCUSSION: Horses were responsible for 75% of the traumas sustained by ranchers and 83% of the traumas sustained by dudes. Bulls were responsible for 94% of the cases involving cowboys. Simply standing near livestock was dangerous for 6% of the sample, including young children. Although helmets and steel-toed boots are currently unpopular, wearing them is a simple and important safety strategy.

Accidents, Occupational↗
PubMed2000

Armadillo exposure and Hansen's disease: an epidemiologic survey in southern Texas.

BACKGROUND: Naturally occurring leprosy has been demonstrated in wild nine-banded armadillos (Dasypus novemcinctus ). This suggests a possible mode of transmission of human leprosy in regions where armadillo contact is prevalent. OBJECTIVE: Our purpose was to study the possible relationship between armadillo exposure and Hansen's disease. METHOD: One hundred one patients (67 men, 34 women) with established Hansen's disease seen in the Hansen's Disease Clinic in Houston, Texas, were questioned about their exposure to armadillos. These patients were divided into two groups: Asian (n = 32) and non-Asian (n = 69). RESULTS: Seventy-one percent of the non-Asian patients surveyed reported either direct or indirect armadillo exposure. None of the Asian patients reported armadillo exposure (P <.001). Of the non-Asian patients, 75.4% had lepromatous disease versus 50.0% of the Asian patients (P <.001). The average age at diagnosis for the non-Asian group with Hansen's disease in this study was 51 versus 38 years for the Asian group (P <.001). CONCLUSION: Although it is yet to be determined whether direct transmission from the armadillo to human occurs, it is likely based on the high incidence of armadillo exposure in non-Asian patients with Hansen's disease in our study population that this animal acts as a reservoir for human disease. However, the Asian patients reporting no known armadillo exposure likely obtained the disease from person-to-person contact in their respective countries of origin where Hansen's disease has a much higher prevalence.

Adolescent↗
PubMed2000

Extracranial carotid artery aneurysms: Texas Heart Institute experience.

BACKGROUND AND PURPOSE: Aneurysms of the extracranial carotid artery (ECA) are rare. Large single-institution series are seldom reported and usually are not aneurysm type-specific. Thus, information about immediate and long-term results of surgical therapy is sparse. This review was conducted to elucidate etiology, presentation, and treatment for ECA aneurysms. METHODS: We retrospectively reviewed the case records of the Texas Heart Institute/St Luke's Episcopal Hospital, Houston, and found 67 cases of ECA aneurysms treated surgically (the largest series to date) between 1960 and 1995: 38 pseudoaneurysms after previous carotid surgery and 29 atherosclerotic or traumatic aneurysms. All aneurysms were surgically explored, and all were repaired except two: a traumatic distal internal carotid artery aneurysm and an infected pseudoaneurysm in which the carotid artery was ligated. RESULTS: Four deaths (three fatal strokes and one myocardial infarction) and two nonfatal strokes were directly attributed to a repaired ECA aneurysm (overall mortality/major stroke incidence, 9%); there was one minor stroke (incidence, 1.5%). The incidence of cranial nerve injury was 6% (four cases). During long-term follow-up (1.5 months-30 years; mean, 5.9 years), 19 patients died, mainly of cardiac causes (11 myocardial infarctions). CONCLUSION: The potential risks of cerebral ischemia and rupture as well as the satisfactory long-term results achieved with surgery strongly argue in favor of surgical treatment of ECA aneurysms.

Adult↗
PubMed2004

Metacercariae of Clinostomum attenuatum in Ambystoma tigrinum mavortium, Bufo cognatus and Spea multiplicata from west Texas.

Tissues from barred tiger salamanders (Ambystoma tigrinum mavortium), Great Plains toads (Bufo cognatus) and New Mexico spadefoots (Spea multiplicata) collected from 16 playa wetlands in Texas during 1999 and 2000 were examined by light microscopy. Digenean cysts were primarily distributed subcutaneously throughout the specimens and occasionally coelomic invasion was noted. The parasites within the cysts were 1.5-2 mm in diameter, with a thin (c. 10 microm wide) eosinophilic-staining tegument, two suckers (oral and ventral), posteriorly located primordial genitalia and paired digestive caeca. These digeneans were identified as the metacercariae of Clinostomum attenuatum. This is the first record of Clinostomum attenuatum in these amphibian species.

Ambystoma↗
PubMedDate not supplied

An investigation of mortality from cancer and other causes of death among workers employed at an east Texas chemical plant.

The cause-specific mortality of 2,510 males employed at an east Texas chemical plant was examined in a historical prospective study to evaluate a suspected increase in deaths from multiple myeloma and brain cancer. Potential exposures from chemicals, either used in manufacturing processes or produced during the study period 1952-1977, included the fuel additive tetraethyl lead, ethylene dibromide and dichloride, inorganic lead, and vinyl chloride monomer. Overall mortality for all workers (156 observed vs. 211.14 expected) and for workers first employed between 1952 and 1959 (131 observed vs. 167.33 expected) when tetraethyl lead was the single major product was lower than expected when compared to the United States general population. There were no significant increases in mortality from malignancies or other causes of death. The deficits may be due to the small number of total deaths, and the low power for detecting excess risk of mortality from multiple myeloma (Z1-beta = 27, alpha = .05), brain cancer (Z1-beta = 31, alpha = .05), or other rare causes of death; lack of complete workplace exposure data for production workers; and the absence of historical measurements on the extent of environmental exposure to tetraethyl lead and other chemicals.

Actuarial Analysis↗
PubMedDate not supplied

Drug use among Texas alternative school students: findings from Houston's Safer Choices 2 Program.

Self-report drug use data were collected from 494 alternative school students, grades seven through 12, surveyed through the Safer Choices 2 study in Houston, Texas. Data were collected between October 2000 and March 2001 via audio-enabled laptop computers equipped with headphones. Twenty-eight percent of the sample reported past-month marijuana use, and 10% reported past-month opiate/codeine use. Males were almost twice as likely as females to have used cocaine during the past month, and over four times as likely to have used opiates/codeine during the past month. Students 16 years and older and were twice as likely to have ever used cocaine and opiates/codeine than students under 16 years. Latinos were 10 times more likely than Blacks to have ever used cocaine; Blacks were twice as likely as Latinos to have used opiates/codeine during the past month. Males were twice as likely as females to have tried "fry," a new street drug made of tobacco or marijuana mixed with embalming fluid and PCP. These new drug trends are startling because they indicate a potential for long-term treatment services for abusers.

Adolescent↗
PubMed1995

Maria: developing a culturally-sensitive treatment plan in pre-hospice south Texas.

This is a case study of a young Mexican-American woman who suffered from end-stage renal disease and severe depression in Texas, before the availability of hospice care. The patient, while struggling to retain her cultural identity in a renal care unit which stressed efficiency, was labeled noncompliant by the medical team. Through knowledge gained from staff discussions, the medical team was able to integrate cultural sensitivity and hospice principles into the treatment plan. With an increased focus on her psychosocial needs, the patient was able to die with a sense of dignity and cultural integrity.

Adult↗
PubMed1999

Analysis of Texas & New Mexico Hospice Organization's new Code of Ethics.

Unique among professional codes of ethics is the Texas & New Mexico Hospice Organization's Code of Ethics. Where other codes concentrate only on principles-based ethics, this new code identifies five models of bioethics currently used in resolving ethical dilemmas. This report's primary purpose analyzes the code's four precepts in the context of (1) principles-based ethics, (2) casuistic-based ethics, (3) covenant-based ethics, (4) evidence-based ethics and narrative-based ethics. The second purpose is to present the practicality of these often esoteric concepts in the day-to-day work of palliative care providers. Indications are that this code of ethics, because of its broad scope, is more useful than other principles-based-only codes.

Ethics, Institutional↗
PubMed1996

Assessing the health behaviors of Texas college students.

The authors of this study examined the health behaviors of Texas college students, using a telephone survey to assess 1,408 randomly selected students enrolled in 23 institutions of higher education. Eighty-nine percent of those surveyed had consumed alcohol at least once, and nearly one third considered themselves regular smokers. More than 81% reported they had had sexual intercourse at least once, and one fourth of the sexually active men had had more than 10 partners. However, of the 1,148 students who were sexually active, only 40.1% reported using a condom at last intercourse. Almost 59% of the students surveyed had never been taught about HIV or AIDS in any of their college classes. Given the large sample size and the random methods employed, the authors suggest that the results of this study can be used to establish a baseline of information regarding health behaviors of college students that can be extrapolated to college populations across the country.

Adult↗
PubMed2001

Colorectal cancer screening by primary care physicians in Texas: a rural-urban comparison.

BACKGROUND: Little is known about colorectal cancer (CRC) screening practices of primary care physicians (PCPs) in rural versus urban locations. METHODS: The authors surveyed 3,380 PCP members of the Texas Medical Association (TMA), stratified by specialty and rural/urban status. Factors associated with PCPs' self-reported practices of CRC screening by fecal occult blood test (FOBT) and/or flexible sigmoidoscopy (SIG) were examined using chi-square tests and multivariate regression. RESULTS: Over 80% of both rural and urban PCPs reported CRC screening with the FOBT, while 70% reported screening with SIG. Many reported doing FOBTs in the office versus using the take-home kit. Variations were found in recommended ages and screening intervals among all respondents. CONCLUSIONS: Geographic location was less important than knowledge and attitudes in predicting PCPs' CRC screening practices. More specific education regarding CRC screening guidelines needs to be directed towards all PCPs.

Adult↗
PubMed1991

Use of a modified Delphi technique to guide coordination of cancer education in Texas medical schools.

Delphi technique is a method of structuring group communication and is useful in achieving consensus on goals, plans, or positions. The Delphi technique was used to determine a course of action to enhance cancer education at each of eight medical schools in Texas. Participants in this study were deans of medicine and a faculty member considered to be the lead cancer expert in the curriculum. A three-generation Delphi study was conducted with the deans using a telephone interview, a personal interview, and a conference of participants, including cancer experts. The Delphi technique was found to be an effective approach for increasing awareness of the statewide cancer plan, for involving all medical schools in achieving the goals of the plan, and for identifying means for enhancing cancer education at each medical school. A consensus was reached to develop a statewide standardized assessment of graduating medical students' knowledge about principles of cancer prevention and screening. The results could serve as a means of determining cancer education needs at each medical school.

Communication↗
PubMed1992

Cancer prevention practices among Texas primary care physicians.

Primary care physicians are uniquely positioned to practice primary and secondary cancer prevention. However, despite a positive commitment, many physicians are pessimistic about the success of their interventions. This study describes the self-reported cancer prevention practices and perceived obstacles of 1600 Texas primary care physicians. These practices differed by primary care specialty and by length of time in practice. Time constraints were uniformly perceived as the leading obstacle to the provision of smoking cessation counseling. High cost, lack of third-party reimbursement, and poor patient compliance were cited as the leading barriers to patient referral for screening mammography. Professional education should stress to physicians that interventions need not be elaborate, expensive, or time consuming, the main purpose being to motivate and reinforce patient behavior. The special challenges of introducing health promotion activities into the clinical setting must be addressed with practical aids such as prompting systems, flowsheets, and computer-based aids for monitoring compliance rates.

Female↗
PubMed1995

Oncology education needs survey of registered nurses in Texas.

In response to the need to determine continuing education priorities in oncology nursing, the Nurse Oncology Education Program surveyed a geographically stratified random sample of Texas registered nurses concerning their oncology practices, perceived skill levels, and personal needs for training in 61 topics areas. The 378 respondents rated their skill levels low to medium, although 62% cared directly for patients with cancer. The highest-rated priorities for professional education were: legal issues, issues and trends in cancer care, investigational/new drug development, and bone marrow transplantation. Nurses employed in community settings and those living outside metropolitan areas tended to indicate the highest numbers of strong training needs. However, comparison of the needs for cancer prevention and detection education by regions showed that for none of the geographic regions was a high training need for cancer prevention and detection identified.

Clinical Competence↗
PubMed1996

Breast cancer screening practices among Cambodian women in Houston, Texas.

BACKGROUND: Faced with Western medicine and a health care system that is unfamiliar, Cambodian women experience barriers to breast cancer prevention activities and thus are seldom reached through current breast cancer education and prevention activities. This study examined the knowledge, attitudes, and practices of breast cancer screening among Cambodian women in Houston, Texas. METHODS: Two hundred sixteen Cambodian women aged 18 years or older were surveyed by telephone. RESULTS: Logistic regression analysis identified five variables as significant predictors of ever having had a clinical breast examination: perceived barriers to clinical breast examination, income, written-language acculturation, knowledge about clinical breast examination recommendations, and education in the United States. Education and knowledge of mammography were found to be important predictors of mammography. Language acculturation variables were not associated with ever having had mammography. CONCLUSIONS: The rate of breast cancer screening among Cambodian women in Houston is lower than that for all women in the United States. These results underscore the importance of developing culturally and linguistically appropriate breast cancer prevention activities for Cambodian women, who face cultural and language barriers to traditional services.

Acculturation↗