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At least 811 records · Page 45Linked to original sources
PubMed2004

Symptoms of insomnia among adolescents in the lower Rio Grande Valley of Texas.

STUDY OBJECTIVES: To estimate the prevalence of symptoms of insomnia among adolescents living along the United States-Mexico border and to examine whether ethnicity and birthplace affect risk for such symptoms. DESIGN: Cross-sectional school-based survey using a version of the 2001 Youth Risk Behavior Survey, modified to elicit data on sleep problems. SETTING: A probability sample of 13 high schools selected from more than 40 high schools in the 4 southernmost counties in Texas-the Lower Rio Grande Valley-contiguous with Mexico. PARTICIPANTS: All ninth-grade students who agreed to participate (n = 5,118). MEASUREMENTS: The sleep module consisted of queries about trouble initiating asleep, trouble maintaining sleep, early morning waking, nonrestorative sleep, quality of sleep, and amount of sleep. RESULTS: Symptoms of insomnia were common, with 12.4% of respondents meeting symptom criteria for insomnia almost every day of the past month. Females were more likely to report insomnia, as were youths reporting lower socioeconomic status. Crude odds ratios suggested foreign-born and those who identified themselves as "Mexican" rather than "Mexican American" were at lower risk of insomnia. However, multivariate analyses eliminated these differences. CONCLUSIONS: More comparative research is needed to ascertain whether and how ethnic culture affects risk for disordered sleep.

Adolescent↗
PubMed2006

Variable co-diagnosis of plagiocephaly and torticollis in Texas health care facilities.

Diagnosis of positional plagiocephaly has increased as babies have been put to sleep supine. The literature varies in reported co-incidence of sternocleidomastoid torticollis, as well as in definition of torticollis as a defect. Statewide data from the Texas Birth Defects registry was analyzed for the diagnosis of plagiocephaly with or without co-diagnosis of torticollis. There were 172 facilities with at least 1 diagnosis of plagiocephaly. Of these, 18 facilities had recorded >20 cases and 3 facilities had recorded >150 cases. In the 18 facilities, percentage of plagiocephaly/torticollis co-diagnosis ranged from 5% to 67%. Two facilities specialize in orthopedic or neurologic problems, but the rest are general pediatric facilities. The three facilities with the most cases showed co-diagnosis of 10% (16 of 159 cases), 29% (108 of 376 cases), and 54% (122 of 228 cases). It is noted that the three largest facilities use different professionals and different medical specialists in evaluation of cases. These data suggest that the wide range in torticollis diagnosis is less likely to reflect true patient variability than an inconsistently applied definition of the defect. Other factors that may play a role are diagnosis by non-MD medical professionals, involvement of different MD specialists in different facilities and diagnosis-dependent but variable insurance reimbursement.

Diagnosis, Differential↗
PubMed1976

A computer-assisted admission matching system for the University of Texas medical schools.

The feasibility of a computer-assisted admission matching system was investigated in 1973-74 at the Medical and Dental Application Center at the request of the four University of Texas medical schools. Preference data were gathered from applicants and from schools, and matching simulation was conducted concurrently with actual admission action for 1974 entering classes. Implementation of a matching system for admission of the 1975 entering classes was demonstrated to be feasible, and a decision to implement such a system was made. Data indicating the need for a matching system are briefly reviewed, and the matching concept is discussed. Results of the 1974 feasibility study are presented, and the first year of implementation for the 1975 entering classes is described. Admission matching improved the efficiency of the admission process by reducing the number of unproductive offers of admission and by providing more applicants earlier decisions from participating schools regarding their applications.

Computers↗
PubMed1997

Using a cost-construction model to assess the cost of educating undergraduate medical students at the University of Texas--Houston Medical School.

PURPOSE: To assess the cost of educating undergraduate medical students at the University of Texas-Houston Medical School (UT-Houston) in 1994-95 through the use of a cost-construction model developed elsewhere and adapted for UT-Houston. METHOD: The cost-construction model identified the cost of the entire program as well as instructional costs (the cost of activities related to direct-contact teaching), educational costs (instructional costs plus the costs of general supervision), and milieu costs (educational costs plus the costs of research). The model predicted these costs based on student contact hours, student enrollment, full-time-equivalent (FTE) faculty and residents required, professional-activity profiles, faculty and resident salaries, and supporting resource costs. Sensitivity analysis was used to explore the effects of such factors as institutional overhead, joint products, volunteer faculty, residents, and varying assumptions about the percentage of time the faculty dedicated to direct-contact teaching. RESULTS: The four-year undergraduate medical program at UT-Houston had a total cost of $82,692,280. For an average class of 200 students, the annual per-student instructional, educational, and milieu component costs were $43,993, $57,370, and $90,660, respectively. The program required 201 FTE faculty members and 258 FTE residents. Sensitivity analysis revealed the financial effects of the various factors, some of which increased costs and some of which decreased costs. CONCLUSION: Although the cost-construction model is conceptually straightforward, there are several inherent complexities and aspects open to debate that must be understood in its application: for example, assumptions regarding faculty time; assumptions regarding the allocation of faculty time to various activities; the definition of those activities; the difficulty of separating costs; the difficulty of accurately defining total educational costs; and so on. However, this study provides a starting point for identifying the distinct costs associated with an undergraduate medical school program and should encourage further discussion and research.

Costs and Cost Analysis↗
PubMed2003

Medical Humanities at the University of Texas Medical Branch at Galveston.

The Institute for the Medical Humanities of the University of Texas Medical Branch at Galveston (UTMB) was established in June 1973 to ensure that humanities teaching and research became an integral part of the education of future scientists and health-care professionals at UTMB. The multidisciplinary faculty of the Institute-who currently represent the disciplines of art, drama, history, law, literature, philosophy, and religious studies-teach in all four years of the undergraduate medical curriculum as well as in various residency programs. In addition to its focus on students and residents in the School of Medicine, the Institute has a vibrant graduate program in medical humanities with several joint degree options, including an MD/MA and an MD/PhD program, and the Institute has always included the School of Nursing, the School of Allied Health Sciences, and the Graduate School of Biomedical Sciences in its activities. After 30 years, the Institute's commitment to health-professional education remains strong and enduring. Challenged by major curriculum reform in the School of Medicine and increasingly tight state budgets, Institute faculty members look forward to continued collaboration with their basic science and clinical colleagues to improve our evolving curriculum and to seek research funding from external sources.

Curriculum↗
PubMed2003

On Becoming a Humanities Curriculum: the Center for Medical Humanities and Ethics at the University of Texas Health Science Center at San Antonio.

The authors describe the development and implementation of a new longitudinal and integrated humanities curriculum in the School of Medicine at the University of Texas Health Science Center at San Antonio. Included are a history of ethics and humanities education in the medical school leading to the creation of the Center for Medical Humanities and Ethics in July 2002; an articulation of the Center's basic principles; a curricular blueprint outlining the core objectives and methodologies, such as a narrative approach of this required, four-year humanities curriculum for undergraduate medical students; and an overview of course materials and activities.

Curriculum↗
PubMed2001

The who, what, why, and how of point-of-care testing: one city's experience in the Group for South Texas Ancillary Testing (GSTAT).

San Antonio, Texas, is the eighth largest city in the United States and has several distinct hospital systems. For-profit and not-for profit hospitals exist in the city along with a county hospital and multiple military institutions. This article compares and contrasts the structure of point-of-care testing (POCT) programs in the five largest systems. Specifically, inpatient glucose testing is examined. This comparison includes the nursing responsibilities and fiscal components of the programs, including billing.

Blood Chemical Analysis↗
PubMed1997

Notices of violation issued to Texas radioactive material licensees inspected in 1995.

Notices of violation stemming from the inspection activities of the Texas Department of Health's Bureau of Radiation Control during calendar year 1995 are summarized and characterized. Although eight distinct general categories of radioactive material licenses were included in the analysis, certain general trends were noted, permitting the formulation of an objective list of the ten most frequent violations cited. In order ranked from the most frequent, these include not following operating or safety procedures, radiation surveys not being performed, inadequate personnel monitoring records, instrumentation not used or out of calibration, radioactive material inventories not performed, leak tests not performed, deficiencies in training for industrial uses, inadequate inspection and maintenance of devices, unauthorized users of radioactive material, and incomplete or absent records for receipt or transfer of radioactive material. Although the analysis was limited to a single state, the results can benefit radiation protection quality assurance programs and health physics continuing education efforts by objectively identifying areas commonly cited for being deficient. The results also reiterate the necessity for proper documentation, as at least seven of the ten most frequent violations issued appear to stem predominantly from the records of radiation protection programs.

Health Physics↗
PubMed2000

Radiation safety program outcomes as indicated by regulatory compliance activities from 1988 to 1997 in Texas.

Occupational radiation protection programs rarely encounter readily observable workplace injuries or illnesses, so upper management must rely on different indicators of relative performance. In many cases, the number of violations, complaints, and reported incidents is used. As with reported workplace injury and illness data, violation, complaint, and incident data provide only a crude indication of a radiation protection program's overall effectiveness. Even so, it is important to recognize that tangible program outcome measures such as these often dictate management decisions. Hence, safety professionals should have access to baseline violation, complaint, and incident trend data so that more informed preventive strategies can be put into place where possible. To assess the outcomes of radiation protection programs in Texas, data from regulatory compliance activities for a 10-y period, inclusive of calendar years 1988 to 1997, were assembled, summarized, and independently verified. For licensees of radioactive material, the ten most frequently cited violations represented 64% of the total issued during the study period. For registrants of radiation producing devices, the ten most frequently cited violations accounted for 73% of the total. A particular emphasis on proper recordkeeping is evident, and should be noted by any internal radiation protection quality assurance programs. Regardless of the permit type, the vast majority of violations issued were classified as low severity. Licensees were found to be involved in approximately 73% of the incidents recorded, with overexposures and badge overexposures representing the largest identifiable types. Registrants were found to be involved in approximately 57% of the complaints recorded, with the largest identifiable issue being concerns about health care provider qualifications or performance. Although this study was limited to a single state, the results can be of benefit to both quality assurance programs and professional health physics training courses by objectively identifying the areas commonly found to be deficient.

Humans↗
PubMedDate not supplied

Focus on: The Methodist Hospital, Houston, Texas, Biomedical Instrumentation Department.

The Methodist Hospital in Houston, Texas, is a 1,527-bed, tertiary care teaching hospital that is both a national and international referral center for medical care in many medical and surgical specialties. The Biomedical Instrumentation Department provides services throughout the hospital in all aspects of clinical equipment management and clinical engineering. With 29 employees and an annual budget of $2.1 million, the department enhances efficiency in the delivery of quality medical care.

Biomedical Engineering↗
PubMed1983

The impact of outpatient department and emergency room use on costs in the Texas Medicaid Program.

Medicaid claims data for a 35% random sample (n = 146,167) of persons receiving benefits from Aid to Families with Dependent Children, and who were eligible for Medicaid in Texas in 1980 are used to examine the impact of outpatient department (OPD)/emergency room (ER) care. Average cost is estimated for OPD/ER and private physician (MD) visits. Persons are also classified by primary source of care. Data on age, race, sex, residence, and months eligible in 1980 permitted prediction of statistically adjusted differences between OPD- and MD-oriented persons for number of ambulatory visits, probability of hospitalization, 1980 total costs, and both hospital episode institutional amount paid and length of stay. OPD/ER visits were found to be $23 more expensive than MD visits. OPD-oriented persons had fewer ambulatory visits, slightly more hospitalizations, greater total and episode costs, and longer lengths of stay than did MD-oriented persons. Potential cost savings are projected.

Adolescent↗
PubMed1992

The impact of the Texas 1989 motorcycle helmet law on total and head-related fatalities, severe injuries, and overall injuries.

The State of Texas implemented a mandatory total motorcycle helmet law for all operators and passengers, effective September 1, 1989. In this study the impact of this intervention on frequency of both total and head-related fatalities, severe injuries, and overall injuries for operators during the subsequent year was quantified. This quantification is important because 26 states in the United States fail to have strict, mandatory helmet laws. The Box-Tiao time-series intervention methodology is used to estimate secular trends before and changes after the implementation of the law, analyzing Department of Public Safety monthly injury accident data for a period of 6 years collected from traffic accident reports filed for each motorcycle injury accident. Trends in fatalities and injuries (except for head-related deaths) estimated before implementation of the law approximated the 9.4% average annual decline in motorcycle registrations. Additional declines of 12.6% and 57.0%, respectively, were estimated for total and head-related fatalities during the year after the law was implemented. Declines of 13.1% and 54.6% were estimated for severe injuries for total and head-related accidents. Declines of 12.3% and 52.9% were found for total and head-related injuries overall.

Confidence Intervals↗
PubMed2001

Nocardiosis in South Texas children.

Primary cutaneous nocardiosis can present as cellulitis or abscess with or without lymphadenitis. In South Texas children with suspected Staphylococcus aureus or Streptococcus pyogenes skin and soft tissue infections who do not improve as expected with appropriate antibiotics, physicians should consider Nocardia brasiliensis in the differential diagnosis, especially if there are multiple lesions in a lymphocutaneous distribution.

Abscess↗
PubMed1999

The epidemiology of syphilis in the waning years of an epidemic: Houston, Texas, 1991-1997.

BACKGROUND: National and local syphilis rates have fallen since 1990. Accurate epidemiologic information about the distribution of syphilis during the waning years of an epidemic are important to health care organizations so that they can specifically target screening and intervention programs. GOALS: To describe the epidemiology of syphilis in Houston, Texas, from 1991 through 1997. STUDY DESIGN: Descriptive evaluation of morbidity surveillance data from the Houston Department of Health and Human Services. RESULTS: Between 1991 and 1997, rates for syphilis fell 61%. Rates for primary and secondary syphilis fell 90% among men and women in all race/ethnicity groups; early latent rates fell 81% among blacks, 57% among Hispanics, and 50% among whites. Late latent rates were stable among blacks and whites and increased among Hispanics. The proportion of total cases identified as late latent disease increased from 16% in 1991 to 63% in 1997. Congenital syphilis rates have remained at approximately 2 per 1,000 live births since 1993. CONCLUSION: Syphilis continues to be a problem in Houston. The medical community and HIV/STD prevention programs need to be vigilant in actively screening high-risk individuals to identify syphilis at earlier stages of the disease and to prevent congenital syphilis.

Adult↗
PubMed1977

Distribution of physicians in family practice and other medical specialties in Texas, 1969-1973: a statistical review.

This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969-1973, for which there are reliable data. Statistical analysis of this information shows that there was a significant difference between the growth of family practice compared to all other medical specialties in both metropolitan and nonmetropolitan counties. This study draws no conclusions that the medical needs in many of these areas are not being met, since patient travel may, to some degree, compensate for disproportionate physician distribution. There is no unanimous agreement on what constitutes an ideal ratio of physicians in any specialty to a population in so-called "medically underserved" areas.

Family Practice↗
PubMed1989

Viscerotropic Rocky Mountain spotted fever in southeastern Texas: report of a survivor with atypical manifestations and multiple organ failure.

A 32-year-old black man from rural southeastern Texas had headache, fever, chills, bronchopneumonia, and an atypical rash, complicated by hypotension, lethargy, confusion, liver dysfunction, thrombocytopenia, and acute renal failure. The diagnosis of Rocky Mountain spotted fever (RMSF) was not suspected until eight days after the onset of symptoms. He was subsequently treated with chloramphenicol, followed by hemodialysis and aggressive supportive therapy. He recovered uneventfully with complete return of renal function. This case emphasizes that RMSF should be considered in the differential diagnosis of any obscure febrile illness even in nonendemic areas.

Adult↗
PubMed1993

The Texas Breast Screening Project: Part I. Mammographic and clinical results.

The 1987 Texas Breast Screening Project was designed to educate women about the benefits and safety of mammographic screening. During the 2-week promotion, 109,339 women called toll-free telephone numbers to inquire about the program, and 64,459 (65%) of 99,650 eligible callers had $50 mammograms at 306 participating community radiology centers. Biopsies were obtained for 1,122 women (1.7% of those screened), and the ratio of benign to malignant biopsy results was 4.2:1. Among the women having biopsies, 214 cancers were found (3.3 cancers per 1,000 women screened). Forty-seven percent of the tumors were not palpable, 80% were smaller than 2 cm, and 72% were clinicopathologic stage 0 or I. These results show that women will respond to an invitation to attend mammographic screening, and that community radiology centers can detect large numbers of early, curable breast cancers.

Adult↗
PubMed1994

Bacterial populations in the groundwater on the US-Mexico border in El Paso County, Texas.

In El Paso County, Texas, 73 domestic wells were sampled using a variety of selective media to determine the extent of bacterial contamination of the groundwater on the US side of the United States-Mexico border. Thirteen wells were contaminated by fecal coliforms, whereas other wells contained a variety of bacterial genera including some potential pathogens that normally would not be detected by standard methods of water testing.

Acinetobacter↗