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Dental caries prevalence in Texas schoolchildren using water supplies with high and low lithium and fluoride.

The effect of lithium (Li) in drinking water on caries prevalence in seven Texas towns was investigated. Children (life-long residents) aged 12-14 years were examined for caries prevalence, as DMFS, in towns with drinking water Li concentrations ranging from 0.0 to 165 micrograms/L and fluoride (F) concentrations ranging from 0.20 to 1.94 mg/L. A significant negative relationship was found between F in drinking water and DMFS. When corrected for the F contribution, Li in water supplies showed a positive correlation with DMFS.

Adolescent↗

A survey of retirement planning by Texas psychiatrists.

Forty-six percent (274 of 600) of the members of the Texas Society of Psychiatric Physicians responded to a mailed survey that addressed retirement issues. Forty-seven percent of respondents were 60 to 69 years of age. Only 12% were female. Ninety-one percent were white, with 86% of respondents married. Only 24% of the sample (66 of 274) were retired at the time of the survey. Although engaged in more than one area of professional activity, 71% were involved in private practice, with 51% practicing in a private office. The major reasons for retiring were "a full life and ready to change pace" (52%) and "retired to pursue other interests" (25%). Twenty percent retired because of physical illness. A mixed financial package formed their retirement package, which included social security (80%), personal savings (73%), Keogh (64%), and state/US government monies (39%). Retired psychiatrists were interested in receiving additional information on successful patterns of retirement (21%), maintaining emotional and physical health (17%), and material on the problems and trials of retirement (15%). Leisure-time activities were varied, and most psychiatrists reported two to four activities. According to 39% of the sample, retirement should be discussed during medical school, 46% indicated that it should be discussed during residency training, and 80% selected Continuing Medical Education courses.

Adaptation, Psychological↗

Medicaid managed care in Texas. What have we learned from the pilots?

Texas has a plan for statewide implmentation of Medicaid managed care by 2001. This article presents evidence from initial demonstration projects, which were implemented in 1993. The 1st-year experience is described and preliminary effects are examined in terms of reactions of clients and providers and changes in utilization patterns and costs of care. Results of the evaluation indicate implementation difficulties with several operational aspects of managed care, variable effects in terms of client and provider reaction to the reform, and little or no change in utilization patterns, but significant cost-savings to the state. Because of the implementation difficulties identified by the evaluation and the mixed results regarding effects, further research is recommended to determine the potential benefit of this reform.

Child↗

Microscopic and ultrastructural studies of necrotizing hepatopancreatitis in Pacific white shrimp (Penaeus vannamei) cultured in Texas.

Granulomatous hepatopancreatitis of unknown etiology has been considered an important disease of Texas shrimp mariculture since 1985. Samples of Pacific white shrimp (Penaeus vannamei) were collected during 1986, 1987, and 1990 from three farms and an experimental mariculture facility with histories of production loss and increased mortality rates. Histologic and ultrastructural examination of shrimp from the four sites demonstrated two morphologically distinct, Gram-negative, double-enveloped, intracytoplasmic bacteria in necrotic hepatopancreatic epithelium. The more numerous small, pleomorphic rod as well as the helical organism are both taxonomically unclassifiable. The helical organism lacked ultrastructural characteristics of previously described helical or spiral bacteria. The relationship between the two organisms is unknown, but the pleomorphic rod is thought to play a major role in the disease. The role of a bacterial agent(s) in subsequent disease episodes is suggested by the observation that the use of oxytetracycline-medicated feed resulted in increased production and survival. Hepatopancreatic tubular epithelial necrosis and shrimp mortality correlated directly with the extent of infection by the small pleomorphic rod. Individual discrete bacteria were identified microscopically by Steiner and Steiner's method. Three major developmental stages of the disease were characterized based on the extent and number of hepatopancreatic tubular epithelial cells containing bacteria, the degree of tubular interstitial inflammation, and the extent and chronicity of tubular necrosis. Additional studies are needed to clarify the roles of the different bacteria identified and the potential role of environmental factors on the disease process.

Animals↗

Incidence of injury in Texas high school football.

This study was undertaken to determine the incidence of injury in high school football based on evaluation of 100 high schools in the State of Texas during a single football season (1989). Certified athletic trainers were the initial medical professionals providing on-site diagnosis and treatment of all injuries. An injury was defined as: 1) an incident causing an athlete to miss all or part of a single practice or game; 2) any incident treated by a physician; and 3) all head injuries reported to the athletic trainer. Data were collected that allowed calculation of the time of exposure to injury per athlete in the sample. There was 75.5% participation in the study by the certified athletic trainers in the 100 schools. A total of 4399 athletes in varsity football programs participated in the study. There were 2228 injuries, as defined in the study, during the period of study, giving an incidence of injury of 0.506 injury per athlete per year. Severe injuries--those requiring hospitalization--were found in 137 cases, for an incidence rate of 0.031 injury per athlete per year. The incidence of reportable defined injury was calculated to be 0.003 injury per hour of exposure per student athlete. The knee was found to be the most commonly injured anatomic site; the ankle ranked second.

Adolescent↗

Incidence of injury in Texas girls' high school basketball.

We studied the incidence of injury in girl's varsity basketball to characterize injury demographics in high school athletics. We defined a reportable injury as one that occurred during organized practice or competition, resulted in either missed practice or game time, required physician consultation, or involved the head or face. We prospectively evaluated the athletes on team rosters during the 1993 to 1994 season from 100 randomly selected Class 4A and 5A Texas public high schools that employed full-time certified athletic trainers. The 890 student athletes from 80 schools ranged in age from 14 to 18 years. Four hundred thirty-six injuries were reported for a rate of 0.49 per athlete per season. Injury risk, calculated on the basis of exposure time, was 0.4% per hour per athlete. Although game time accounted for only 12.5% of exposure time, it represented one half of the total injuries. Sprains and strains (56%) were the most common injuries, followed by contusions (15%) and dental injuries (14%). Injuries to the ankle (31%) and knee (19%) were by far the most common. There were 34 severe injuries defined as requiring surgery or hospitalization, for a rate of 0.038 per athlete per season. Knee injuries were by far the most likely to require surgeries, and ACL injuries accounted for 69% of the severe knee injuries.

Absenteeism↗

The incidence of injury in Texas high school basketball. A prospective study among male and female athletes.

Recent publications have reported differences in the incidence, rate, risk, and type of sports injury among men and women. We undertook a prospective study to determine the incidence of injury among high school basketball players and to examine the differences in injury type, incidence, rate, and risk between male and female athletes. During a single basketball season, an injury survey of girls' varsity teams at 100 class 4A and 5A high schools in Texas was conducted. These data were previously reported. We surveyed the same 100 high schools during a subsequent season to gather injury data from the boys' varsity teams. The athletic trainer collected data on each reportable injury and reported the data weekly to the University Interscholastic League. A reportable injury was defined as one that occurred during a practice or a game, resulted in missed practice or game time, required physician consultation, or involved the head or the face. The boys' and girls' data were compared and statistically analyzed. The rate of injury was 0.56 among the boys and 0.49 among the girls. The risk of injury per hour of exposure was not significantly different between the two groups. In both groups, the most common injuries were sprains, and the most commonly injured area was the ankle, followed by the knee. Female athletes had a significantly higher rate of knee injuries including a 3.79 times greater risk of anterior cruciate ligament injuries. For both sexes, the risk of injury during a game was significantly higher than during practice.

Adolescent↗

Violent women: findings from the Texas women inmates study.

Prior research on violent crime by female offenders is reviewed. A Texas female prisoner sample is used to explore specific questions raised by the literature review. Violent and nonviolent offenders were compared, looking specifically at race, socioeconomic status, having been raised in single-parent homes, criminal history, gang membership, marital status, and childhood abuse. Findings indicated that women who are violent were more likely to be younger, African American, unemployed, and having extensive criminal histories. They were more likely to come from dysfunctional families with childhood abuse. Limitations of the study were noted.

Adult↗

Insight from a breastfeeding peer support pilot program for husbands and fathers of Texas WIC participants.

A Father-to-Father Breastfeeding Support Pilot Program conducted by the Texas Department of Health provides a model of a viable way to increase breastfeeding rates in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC Program). The pilot concept was based on previous success with a breastfeeding peer counselor program and research documenting the father's attitude as an important influence on a mother's decision to breastfeed. Peer dads are fathers of breastfed infants participating in the WIC Program. They are recruited, trained, and hired to give breastfeeding and parenting information to other WIC fathers. WIC fathers rated the information they received as "very important" and indicated that counseling sessions would help them support their infants'mothers with breastfeeding and be better fathers. Breastfeeding initiation rates increased at clinics employing peer dads. Father-to-father breastfeeding education was successful in educating and empowering fathers, enabling them to support their breastfeeding family members.

Adult↗

Learning to lobby for probreastfeeding legislation: the story of a Texas bill to create a breastfeeding-friendly physician designation.

Legislation can reduce institutional barriers to breastfeeding. Lobbying is the process by which legislation is influenced by a special interest group. While generally thought of as an activity available only to the rich and powerful, lobbying by lactation activists can be an effective way to change public policy. A breastfeeding coalition in central Texas has been involved with lobbying efforts since 1995. Tactical lessons learned are shared to inspire and assist others seeking to pass probreastfeeding legislation.

Breast Feeding↗

A comparison of the use of alternative therapies among Mexican Americans and Anglo-Americans in the Texas Rio Grande Valley.

In a descriptive study with a convenience sample of 60 Mexican Americans and 60 Anglo-Americans, four research questions were asked: (a) What kinds of and how frequently are alternative therapies used by the Mexican Americans and Anglos in the Texas Rio Grande Valley? (b) Is there a difference in the kinds and amounts of therapies used by the two groups? (c) Do the participants self-report this information to their established, conventional, care provider? and (d) What are the participants' subjective reports about these therapies? Findings showed that both groups used alternative practitioners, but that Mexican Americans reported using them more than twice as often as did Anglo-Americans. The most prevalent therapies sought by Mexican Americans were prayer, herbal medicine, massage, relaxation, spiritual healing, and chiropratic. The most prevalent therapies sought by Anglo-Americans were prayer, massage, chiropractic, herbal medicine, megavitamin therapy, and spiritual healing. Almost twice as many Mexican Americans (45%) report discussing their therapies with their established primary health provider than did Anglos (26.7%).

Adult↗

Community readiness to prevent intimate partner violence in Bexar County, Texas.

The purpose of this article is to describe the Community Readiness Model implemented by the San Antonio Safe Family Coalition in Bexar County, Texas, a coordinated community response to prevent intimate partner violence. The project used a participatory action process to (a) determine the city's and county's stage of readiness to prevent intimate partner violence; (b) identify differences in the city and county by dividing the area into sectors for the assessment; (c) engage the community in determining the accuracy and usefulness of the results of the assessment; (d) develop targeted strategies to move the city and county to a higher stage of readiness for prevention of intimate partner violence; and (e) evaluate the results of the project.

Attitude to Health↗

Community social support for Cuban refugees in Texas.

Social support has been linked to positive health outcomes for many populations across multiple health issues. The interactional approach defines social support as a complex, transactional process between the person and his or her social environment. Being part of a community enhances the likelihood of social bonding, leading to increased perceived support. In this study, the authors describe recently arrived adult Cuban refugees' perceptions of community-level support in Texas. Practical and emotional support needs included jobs and companionship away from everyday problems. The two major sources of practical support were resettlement agencies and other Cubans. The two major sources of emotional support were other Cubans and English-speaking friends. There were no local Cuban clubs or associations where Cubans could meet. Besides receiving support, many Cubans were also supporting other Cubans locally and in Cuba, and some experienced discrimination.

Acculturation↗

Home remedies for type 2 diabetes used by Mexican Americans in El Paso, Texas.

The purpose of this article is to examine the use of herbal remedies to treat Type 2 diabetes among Mexican Americans in El Paso County, Texas, on the U.S.-Mexico border. Interviews were conducted in Spanish with 22 Mexican American adults diagnosed with Type 2 diabetes mellitus. Open-ended questions were used to elicit theparticipants' beliefs about the appropriate treatment of Type 2 diabetes, including both Western biomedical and herbal therapy. Kleinman's explanatory model of illness served as the framework, and the grounded theory method was used for data analysis. A majority of participants were taking prescribed Western medications in conjunction with traditional Mexican folk remedies. Participants relied on the advice of family, friends, and neighbors to provide them with guidance, and some herbs used by participants were not indicated for the treatment of diabetes. Health care providers should be aware that Mexican American clients may make choices about herbal remedies without expert guidance and advice.

Adult↗

Overweight and perceived health in Mexican American children: a pilot study in a central Texas community.

This study assessed actual and perceived health status of overweight Mexican American clients at a central Texas school-based health center in a predominantly Hispanic school district. It also explored the participants' interest in making lifestyle changes to promote a healthy weight. A medical records review indicated that of the Hispanic children between the ages of 7 and 12 years, 38% had a weight status at or above the 85th percentile. Assessments were conducted in a sample of these overweight Mexican American children to learn about their medical history, eating and activity patterns, perceived health and body size, and general health-risk status. Weight-related conditions, such as elevated blood pressure and cholesterol levels, were found in more than half the sample. Few consumed fruits and vegetables, and many engaged in only sedentary activities. The majority perceived themselves as "big," wanted to make changes in their body size, and wanted family members to participate in making changes with them. Although most of the sample were in the 97th body mass index percentile, many perceived themselves to be as healthy as or healthier than others. These findings substantiate the need to design and implement a culturally appropriate weight management and obesity prevention program in this community. However, the perception of being healthy in the presence of multiple indicators of poor health may pose challenges to successful intervention.

Child↗

Offender and victim characteristics of registered female sexual offenders in Texas: a proposed typology of female sexual offenders.

Victim and offender characteristic of all registered adult female sexual offenders in Texas (N = 471) were examined. The most common offenses the females were arrested for were indecency with a child--sexual contact, sexual assault on a child, and aggravated sexual assault on a child. The majority (88%) of the females were Caucasian and the ages ranged from 18 to 77 (M = 32). The results of Hierarchical Loglinear Modeling yielded a complex relationship between offender and victim characteristics; thus, identification of preferred victims is mitigated by more than one variable. Additionally, the employment of cluster analysis yielded 6 types of female sexual offenders. The most common group includes 146 offenders, heterosexual nurturers. They were the least likely to have an arrest for a sexual assault. The victims were males who averaged 12 years of age. The other types of offenders included, noncriminal homosexual offenders, female sexual predators, young adult child exploiters, homosexual criminals, and aggressive homosexual offenders.

Adult↗

Is abstinence education theory based? The underlying logic of abstinence education programs in Texas.

Authors examined the logic (or the implicit theory) underlying 16 abstinence-only-until-marriage programs in Texas (50% of all programs funded under the federal welfare reform legislation during 2001 and 2002). Defined as a set of propositions regarding the relationship between program activities and their intended outcomes, program staff's implicit theories were summarized and compared to (a) data from studies on adolescent sexual behavior, (b) a theory-based model of youth abstinent behavior, and (c) preliminary findings from the national evaluation of Title V programs. Authors interviewed 62 program directors and instructors and employed selected principles of grounded theory to analyze interview data. Findings indicated that abstinence education staff could clearly articulate the logic guiding program activity choices. Comparisons between interview data and a theory-based model of adolescent sexual behavior revealed striking similarities. Implications of these findings for conceptualizing and evaluating abstinence-only-until-marriage (or similar) programs are examined.

Adolescent↗

Examining the perspectives of Texas minors cited for possession of tobacco.

This study examined the personal experiences of twenty 14-to-19-year-old Texas youth cited for tobacco possession and attending a court-mandated tobacco awareness class. Guided by labeling theory, focus group questions addressed the process of citation, how youth viewed themselves following citation, how parents and peers viewed youth following citation, and youths' views on the purpose and effects of the policy. Many youth felt stupid for being caught or determined that they were unlucky. Parents were upset that youth were caught smoking; however, most knew their children smoked. Peers felt sympathy for cited youth or made fun of them for being caught. Participants felt that the law was in existence to deter younger children from initiating smoking or to encourage older minors to quit smoking. However, youth also indicated that there was no purpose to the law and that instead of decreasing smoking it could lead to its continuation. Implications for practice are discussed.

Adolescent↗