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PubMed1995

Health services delivery to students with special health care needs in Texas public schools.

A statewide survey of 2,875 Texas public school nurses was conducted to determine the characteristics, needs, and involvement of nurses in the health and education management of students with special health care needs (SSHCN). The 1,574 survey respondents (response rate = 55%) were primarily registered nurses (84%) with a mean of 8.6 years (SD = 7.1) of experience in the school setting. Respondents served 1.5 school campuses on average; the mean nurse-to-student ratio per campus was 1:728 (SD = 518). Respondents identified 106,650 SSHCN (6% of total enrollment). Asthma (47%), attention deficit disorder (26%), and seizure disorders (8%) were the most prevalent conditions encountered among SSHCN. Medication administration (54%), diapering (12%), and inhalation respiratory treatments (11%) were the most common of 48,569 health procedures delivered daily to SSHCN by nurses, clerical staff, assistants, and teachers. Parents were identified as the primary source of both child-specific health (70%) and training (68%) information in the school setting. Although nurses, of all school personnel, are likely best able to speak to the impact of a child's health impairment and needed school services, only 32% of respondents reported routine participation in special education eligibility evaluations and only 18% reported routine attendance at special education meetings for SSHCN. Moreover, 84% and 92%, respectively, reported discomfort at participating in special education eligibility evaluations and attending special education meetings.

Adolescent↗
PubMed1996

A profile of rural Texas adolescents who carry handguns to school.

Students in randomly selected eighth and 10th grade English classrooms (n = 1,072) in central Texas schools were surveyed in fall 1994 regarding carrying weapons to school and associated risk factors. Students who carried a handgun to school one or more times during the preceding 12 months were compared to those who had not done so, using discriminant analysis and chi-square. Gun carrying at school increased 138% from seven years earlier in the same area using the same survey procedures. Most students reported they carried a gun out of fear or anger. Those who carried a gun at school had extremely elevated rates of repeated victimization of several types during the previous year: 589% higher for attack at school, 552% higher for attack outside school supervision, 576% higher for attempts to force sex at school, and 216% higher for rape. They also were more likely to enter dangerous situations repeatedly, were 17 times more likely to have used crack cocaine, had less instruction on preventing violence, less knowledge about means of avoiding fighting, and felt an obligation to fight under a wider variety of situations. Study variables accurately classified 78.4% of gun carriers as such. Researchers concluded that efforts at prevention of handgun violence in schools should include interventions to increase the safety of a select group of vulnerable students, while providing psychological counseling to assist them in overcoming emotional effects of victimization as part of larger violence prevention efforts.

Adolescent↗
PubMed1996

Pro-innovation bias: the case of the Giant Texas SmokeScream.

A common approach to promoting improvements in school health instruction involves development and dissemination of new curricula and teaching materials. Ironically, potential effects of innovative materials on student outcomes and actual teacher instructional practices rarely are considered important in decisions concerning use of new material. This study examined the impact of a new curricular innovation, the Giant Texas SmokeScream (GTSS), on 512 middle grade students' knowledge, perceptions, and behavioral intent about smoking. The data provided a basis for discussion of what Rogers labeled "pro-innovation bias." Data indicated the program had no effect on students. The GTSS program itself, although popular with schools, was questioned as being atheoretical in its approach to health education and ineffective in its outcomes. These data illustrate the need for programs to be based on sound theory and evaluated rigorously prior to general adoption. Additionally, program evaluations focused solely on student effects are insufficient in their assessment of adoption and implementation practices.

Adolescent↗
PubMed1998

School-based management of chronic asthma among inner-city African-American schoolchildren in Dallas, Texas.

Asthma, a chronic disease of the respiratory tract, affects approximately five percent of the U.S. population, including almost five million children. Childhood asthma has been identified as the leading cause of school absences. This study was to examined efficacy of a school-based program to prevent exacerbation of asthma symptoms and manage asthma in school children using measured doses of an inhaled anti-inflammatory medication. The sample consisted of 22 African-American children in one inner-city elementary school in Dallas, Texas, ages 5-12 years with confirmed diagnoses of asthma. For three months, each child came to the school clinic two times per day for medication administration and measurement of respiratory peak flow rates. Data were collected for a number of variables including bronchodilator use, school absences, self-report of asthma symptoms, and number of visits to the physician. During the study, mean peak flow rates improved approximately 15%, and bronchodilator use decreased 66%. Improvement also was evident in several other areas.

Absenteeism↗
PubMed1999

Health risk behaviors of Texas students attending dropout prevention/recovery schools in 1997.

This study determined prevalence of health risk behaviors of 9th through 12th grade students attending dropout prevention/recovery alternative schools in Texas in 1997. Participants were 470 youth whose health risk behaviors were assessed using the Youth Risk Behavior Survey in an anonymous, self-administered format. Behaviors measured included frequency of weapon-carrying and fighting, suicide-related behaviors, substance use, and sexual behaviors. A substantial percentage of alternative school students reported participating in behaviors that placed them at acute or chronic health risk. Differences in the prevalence of risk behaviors were noted by gender, racial/ethnic, and age subgroups. In addition, alternative school students frequently engaged in multiple risk behaviors. These findings suggest a need for comprehensive school-based health education/intervention programs to reduce the prevalence of risk behaviors in populations of alternative school students.

Adolescent↗
PubMed2003

Defining abstinence: views of directors, instructors, and participants in abstinence-only-until-marriage programs in Texas.

This study examined how program directors, instructors, and participant youth from a sample of federally funded abstinence-only-until-marriage education programs in Texas define the term "abstinence" and its object (from what one abstains). A sample of eight programs, from the 32 federally funded programs in the state (funded in fiscal year 2000-2001), were selected for indepth case studies. Interviews were conducted with 29 program staff (10 directors and 19 instructors). Six focus group sessions were held with youth participating in the programs. Interview and focus group transcripts were analyzed qualitatively, with salient themes being coded and counted. Results are presented in terms of frequency of mention of each theme/code. Most respondents (80% of program directors, 89% of instructors, 83% of focus groups) provided definitions of abstinence containing both positive and negative elements. Positive-patterned definitions emphasized specific attitudes and behaviors that must be internalized by youth (Internal Management; Values/Attitudes Incorporation; Abstinence as an Option; Investment in the Future). Negative definitions stressed restraint and avoidance, and focused on the objects of abstinence (Sexual/Vaginal Intercourse; Oral Sex; Anal Sex; Pre-Coital Behaviors; Behaviors with Purpose of Sexual Arousal; Non-Sexual Behaviors). Each element was mentioned by at least 26% of program staff and in at least 17% of youth focus groups. Results indicated substantial variability in how the term "abstinence" is defined. Such variability has implications for development of abstinence education programs, as well as for implementation of valid, equitable, and useful evaluations.

Adolescent↗
PubMed2003

Realized access to physician services among the elderly in West Texas.

The purpose of this study is to identify populations in a sparsely populated region that are less likely to obtain medical care. We conducted a cross-sectional survey of more than 5,000 elderly persons who participated in telephone interviews after being identified through more than 65,000 calls to residential listings. Subjects were persons aged 65 years and older who resided in 108 counties in western Texas. The response rate was 72%. The probability of seeing a physician in the last 6 months for urban and rural residents was modeled using multiple logistic regression analysis. Among rural residents, characteristics that were significantly (p < 0.05) associated with not recently visiting a physician when health status is held constant included belief in home remedies, having less than a high school education, lack of health insurance, and low income. Among urban residents, Hispanic ethnicity and skepticism about medical care were negatively associated with having a recent visit, whereas being religious was positively associated. Despite the availability of Medicare coverage, several subgroups of the elderly population have impaired access to medical care in this sparsely populated region. Intensified outreach efforts are indicated.

Aged↗
PubMed2003

Ancillary community pharmacy services provided to older people in a largely rural and ethnically diverse region: a survey of consumers in West Texas.

Little is known about the quality of pharmacy services provided to the rural elderly population. This exploratory study examines rural/urban and ethnic differences in perceived access to ancillary pharmacy services among elderly people. Two telephone surveys were conducted using directory listings in West Texas to generate a longitudinal sample. Persons aged 65 years and older who were not cognitively impaired were asked to complete the survey. The number of participants in both rounds of the survey was 3,689. Seven ancillary pharmacy services were examined: delivery of medications, medication counseling, written medication information, blood pressure monitoring, blood glucose monitoring, osteoporosis screening, and immunization. The sample was stratified by county of residence (urban, rural, or frontier) and racial/ethnic background. Chi-square tests were performed to detect rural/urban and racial/ethnic differences in access to the seven ancillary services. The association between proficiency in English and access to the services was also examined. Rural residents were more likely than urban residents to report that their pharmacies provide delivery of medications, medication counseling, and immunization services, but they were less likely than their urban counterparts to report that their pharmacies provide blood pressure monitoring. Access to ancillary pharmacy services was reported as poorer by older Hispanic people compared with non-Hispanics. Deficiency in English was significantly related to inequality in reported access to ancillary pharmacy services. It is essential to consider the special needs of rural and Hispanic elderly people to ensure equitable access to ancillary pharmacy services.

Aged↗
PubMed2005

Herbal remedies used by selected migrant farmworkers in El Paso, Texas.

CONTEXT: Little is known about the use of complementary and alternative medicine among the approximately 1.6 million migrant farmworkers in the United States. PURPOSE: To evaluate the use of medicinal plants and natural remedies among a convenience sample of 100 migrant farmworkers living temporarily in a migrant worker center in El Paso, Texas. METHODS: A structured interview instrument was designed to elicit information about reasons for medicinal herb use, form in which herbs were ingested, serious side effects experienced, location of purchase, effectiveness of treatment, and use of allopathic medications. FINDINGS: The majority of workers used herbal remedies or other natural products because they believed them to be more effective than pharmaceuticals and because of tradition. Most learned about herbal remedies from a relative, primarily from their mother, and the majority who used herbal remedies believed them to be very helpful in treating specific illnesses. No adverse reactions to any herbal remedy were reported. The majority of participants did not inform their physician about their use of herbal remedies. According to the literature, potential adverse interactions between herbal remedies used and allopathic medications included gastrointestinal irritation, renal toxicity, and hypoglycemia. CONCLUSIONS: Health care providers must be knowledgeable about the use of herbal remedies among migrant farmworkers. By showing an understanding of and sensitivity to the use of these remedies, health care providers will be able to conduct more comprehensive health assessments of migrant workers and their families and provide them with more culturally competent care.

Adult↗
PubMed2005

Teenage pregnancy in the Texas Panhandle.

PURPOSE: This study compares rural and small-city teenage and adult pregnancies, with respect to complication rates and pregnancy outcomes. METHODS: Chart review of Medicaid patients (513 teenage [under 20 years] and 174 adult controls [ages 25-34]) delivered (excluding multiple gestation) in Amarillo, Texas, from January 1999 to April 2001. Demographic data collected included maternal race, gravidity, parity, smoking status, drug usage, presence of antenatally diagnosed sexually transmitted disease(s), county type (rural vs small city) and number of prenatal visits. Outcomes included mode of delivery, primary cesarean section rates, preterm birth (<34 or <37 weeks), birth weight, birth weight <2500 g, preeclampsia, total maternal weight gain, hemoglobin changes after delivery, Apgar scores, and neonatal intensive care unit admissions. Statistical comparisons between groups were made for a number of factors and outcomes (P < .05). RESULTS: Teenagers did not have a significantly higher frequency of either illicit drug or tobacco usage, but teenagers <17 years had a greater incidence of sexually transmitted diseases (19.8% vs 10.4%, P < .008) and preeclampsia (7.1% vs 2.3%, P < .025, odds ratio 3.2 [1.1 to 9.9]) when compared with adults. The total weight gain was highest for teens < or =17 years (36.4 pounds vs adults: 28.2, P < .001). The primary cesarean section rate was higher in adults (all teens 18.5% vs adults 38.6%, P < 001). County rurality had no impact on any of the observed findings or variables tested. CONCLUSIONS: Young teenagers have a higher incidence of sexually transmitted diseases and preeclampsia and also gain significantly more weight with pregnancy than young adults. However, the pregnancy outcomes were no different for rural vs small city teens.

Adolescent↗
PubMed1982

A progress report: the investigation of brain tumors at the Texas Division of Dow Chemical.

During the six-month period since this investigation was initiated, an increased risk of death due to brain tumor was linked with employment at the Texas Division of Dow Chemical by the results of a case-control study based on county death certificates. Specifically, the county-based case-control study yielded an odds ratio of 2.54 with a 90% confidence interval of the odds ratio extending from 1.23 to 6.80. Additional investigations were initiated which resulted in the ascertainment of 25 brain tumor deaths among former Dow employees. Of these cases, 84% were initially employed between 1940 and 1946 and 64% can be described as glioblastomas or astrocytomas grade III and IV. Detailed protocols have been developed for a sample-based cohort study and a series of in-plant case-control studies. The sample-based cohort study is nearing completion and the in-plant case-control studies are anticipated to begin in the near future. The study design serving as the framework of this investigation represents a modest departure from the traditional epidemiologic study designs. This sample-based approach was designed to circumvent or minimize the usual problems associated with the use of massive collections of data that have been partially automated, if at all. The anticipated benefits will be conservation of limited staff resources and a reduction of the time necessary to complete a large-scale epidemiologic investigation.

Adult↗
PubMed1976

Cost-benefit analysis of fluoridation in Houston, Texas.

Most previous cost-benefit analyses of fluoridation programs have been retrospective in approach and have biased their results in favor of fluoridation. This study performed a prospective cost-benefit analysis of fluoridating a segment of the water supply for Houston, Texas, and explicitly introduced and evaluated the time pattern of the costs and benefits. It was shown that neglect of the time structure of the costs and benefits would significantly bias the results. A benefit-cost ratio of 1.51 and a net present value (or "social profit") of $1,102,970 were found. The results are biased downwards and should be considered a lower bound. Thus the results indicate an investment in a fluoridation program by Houston would be a socially profitable one.

Adolescent↗
PubMed1965

HEMOGLOBIN F TEXAS: GAMMA-CHAIN VARIANT.

An abnormal fetal hemoglobin, designated hemoglobin F(Texas), was found in the cord blood of five Negro infants (all related and three of them siblings) and of one Caucasian infant. Studies on the chemical structure of this variant indicate that there is a substitution of a lysyl residue for either the fifth or sixth glutamyl residue of the gamma-chain.

Chromatography↗
PubMed2000

Research misconduct. Texas scientist admits falsifying results.

A University of Texas (UT) immunologist has admitted to federal officials that he falsified research results over at least a 5-year period, leaving a trail of retracted papers and disgruntled collaborators. The scientist, who resigned and has been barred from receiving federal research grants, was found to have repeatedly duped colleagues by spiking test tubes with doses of a radioactive marker that produced positive results, according to detailed reports by UT and federal investigators.

Allergy and Immunology↗
PubMed2005

Vancomycin-resistant Enterococcus faecium strains isolated from community wastewater from a semiclosed agri-food system in Texas.

Vancomycin-resistant Enterococcus faecium strains (VRE) were isolated from human wastewater but not swine fecal waste from a semiclosed agri-food system in Texas. Forty-nine VRE isolates possessed vanA, and one possessed vanB. Twenty-one pulsed-field gel electrophoresis types were identified and segregated into three groups. There was evidence of clonal dissemination among geographically separated sites.

Agriculture↗
PubMed2005

Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection occurs commonly in children. Clindamycin resistance may be inducible or constitutive, and the rates of inducible resistance in CA-MRSA that could produce clindamycin treatment failures vary worldwide. The double-disk test was performed in 197 erythromycin-resistant and clindamycin-susceptible CA-MRSA strains from children in Dallas, Texas, from 1999 to 2002 to determine inducible clindamycin resistance. Resistance mechanisms were studied by PCR; epidemiologic trends were studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Inducible resistance was demonstrated in 28 (93%+/-6%) of 30 tested isolates in 1999, 21 (64%, +/-11%) of 33 in 2000, 12 (23%+/-7%) of 52 in 2001, and 6 (7%+/-3%) of 82 in 2002. All noninducible strains had the msr(A) gene. Among inducible resistant strains, 31 had erm(B), 24 had erm(C), and 12 had erm(A) genes. Two distinct pulsed types were the most prevalent; one of them was the most common pulsed type in 1999, whereas in 2002 a different pulsed type was prevalent. MLST analyses determined that ST-8 was the most common type, with 76%+/-5% found in 2002. All but one of these clindamycin-susceptible, erythromycin-resistant ST-8 strains showed no induction of clindamycin resistance. We conclude that, among erythromycin-resistant, clindamycin-susceptible CA-MRSA strains isolated from children in Dallas, inducible methylase resistance became less common from 1999 to 2002 (P<0.001). The phenotype of strains was associated with their sequence type. Our results demonstrate a clonal shift in CA-MRSA in Dallas children from 1999 to 2002.

Adolescent↗
PubMed1979

Enterobacteriaceae isolated from iguanid lizards of west-central Texas.

The prevalence of members of the family Enterobacteriaceae in the intestines of seven species of iguanid lizards native to west-central Texas was determined. Of the 67 lizard specimens examined, 48.7% were infected with Salmonella and 9% were infected with Salmonella arizonae. Two lizard species (Sceloporus olivaceus and Crotaphytus collaris) were shown to have a 100% prevalence of Salmonella.

Animals↗