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At least 973 records · Page 54Linked to original sources
PubMed1999

An epidemic of congenital syphilis in Jefferson County, Texas, 1994-1995: inadequate prenatal syphilis testing after an outbreak in adults.

OBJECTIVES: After a syphilis epidemic in Jefferson County, Texas, in 1993 and 1994, congenital syphilis prevalence and risk factors were determined and local prenatal syphilis screening practices were assessed. METHODS: Medical records were reviewed, pregnant women with syphilis were interviewed, and prenatal care providers were surveyed. RESULTS: Of 91 women, 59 (65%) had infants with congenital syphilis. Among African Americans, the prevalence per 1000 live births was 24.1 in 1994 and 17.9 in 1995. Of the 50 women with at least 2 prenatal care visits who had infants with congenital syphilis, 15 (30%) had received inadequate testing. Only 16% of 31 providers obtained an early third-trimester syphilis test on all patients. CONCLUSIONS: Inadequate prenatal testing contributed to this outbreak of congenital syphilis.

Adolescent↗
PubMed2000

Hunger in legal immigrants in California, Texas, and Illinois.

OBJECTIVES: This study determined the prevalence of food insecurity and hunger in low-income legal immigrants. METHODS: We conducted a cross-sectional survey of Latino and Asian legal immigrants attending urban clinics and community centers in California, Texas, and Illinois with a food security questionnaire. RESULTS: Among 630 respondents, 40% of the households were food insecure without hunger and 41% were food insecure with hunger. Independent predictors of hunger were income below federal poverty level (odds ratio [OR] = 2.72, 95% confidence interval [CI] = 1.72, 4.30), receipt of food stamps (OR = 2.53, 95% CI = 1.57, 4.09), Latino ethnicity (OR = 2.39, 95% CI = 1.49, 3.82), and poor English (OR = 1.76, 95% CI = 1.10, 2.82). CONCLUSIONS: The prevalence of hunger among low-income legal immigrants is unacceptably high. Access to food assistance programs is important for the health and well-being of this population.

Adult↗
PubMed2001

Environmental health training of promotoras in colonias along the Texas-Mexico border.

Poverty, overpopulation, and a lack of environmental controls have combined with cultural and linguistic division to produce a looming public health threat in unincorporated communities on the US-Mexico border. These rapidly multiplying colonias, from a Spanish term for neighborhoods, are settlements of varying size located along the border. Along the American side of the Texas-Mexico border alone, there are approximately 1800 colonias--the largest number of any border state--most of which lack basic water and sewer systems, paved roads, and safe and sanitary housing. Promotoras, from a Spanish term for lay community educators, are community leaders who live in the colonias and build important bridges between residents and the federal and state bureaucracies. These women have been trained to introduce their neighbors to state "systems" of government, education, and medical and social services that otherwise may lie out of reach. Promotoras are able to "translate" this training into culturally meaningful instruction that empowers community self-development. When neighbors teach neighbors, the message is received with greater trust and readiness to act.

Community Health Workers↗
PubMed2002

A program to increase seat belt use along the Texas-Mexico border.

A school-based, bilingual intervention was developed to increase seat belt use among families living along the Texas-Mexico border. The intervention sought to increase seat belt use by changing perceived norms within the community (i.e., making the nonuse of seat belts less socially acceptable). The intervention was implemented in more than 110 classrooms and involved more than 2100 children. Blind coding, validity checks, and reliability estimates contributed to a rigorous program evaluation. Seat belt use increased by 10% among children riding in the front seat of motor vehicles in the intervention community, as compared with a small but nonsignificant decline in use among control community children. Seat belt use among drivers did not increase.

Child↗
PubMed2004

Measuring the prevalence of overweight in Texas schoolchildren.

OBJECTIVES: We describe results from year 1 of a surveillance system to monitor body mass index in children at the state level. METHODS: A sample of 6630 children attending Texas public schools, weighted to represent 4th, 8th, and 11th grades within race/ethnic subpopulations, was assessed. Body mass index was calculated from measured height and weight; demographic information was obtained from a questionnaire. RESULTS: Prevalence of overweight was 22.4%, 19.2%, and 15.5% for 4th-, 8th-, and 11th-grade students, respectively. Overweight prevalence was highest among Hispanic boys (29.5%-32.6%), fourth-grade Hispanic girls (26.7%), and fourth- and eighth-grade African American girls (30.8% and 23.1%, respectively). Eleventh-grade White/other girls had the lowest prevalence of overweight (5.5%). CONCLUSIONS: These data confirm the increasing prevalence of overweight among US children, especially among Hispanic and African American students compared to White/other students and fourth-grade students relative to 8th- and 11th-grade students.

Adolescent↗
PubMedDate not supplied

Biosolids decomposition after surface applications in west Texas.

In a semiarid environment, climate is a critical factor in the decomposition of surface-applied biosolids. This study examined the effect of 2- to 7-yr exposure times on the composition of single applications of New York, NY biosolids in western Texas. Exposure time effects on organic matter, N, P, S, Cu, Cr, Pb, Hg, and Zn were studied near Sierra Blanca, TX. Due to organic matter decomposition, total organic C decreased from 340 g kg(-1) in fresh biosolids to 180 g kg(-1) in biosolids after 82 mo of exposure, whereas the inorganic ash content of the biosolids increased from 339 to 600 g kg(-1). Total N decreased from 50 to 10 g N kg(-1) and total S decreased from 12 to 6 g S kg(-1). Bicarbonate-available P in the biosolids decreased from 0.9 to 0.2 g kg(-1). Successive H2O extractions yielded soluble P concentrations consistent with dicalcium phosphate (dical) for fresh biosolids and tricalcium phosphate (trical) for biosolids exposed for 59 months or more. Sparingly soluble phosphates, such as dical and trical, potentially yield > 0.5 mg P L(-1) in runoff waters for extended periods after biosolids applications, especially after multiple applications. Selective dissolution of the biosolids indicated that as much as 66 to 78% of P exists as iron phosphates, 16 to 21% as Fe oxides, and 5 to 12% as insoluble Ca phosphates. Chemical analyses of ash samples suggest that Cu and Zn have been lost from biosolids through leaching or runoff and no losses of Pb, Cr, or Hg have occurred since application.

Conservation of Natural Resources↗
PubMed1989

Patterns and economic effects of drug overdose mortality in Texas: 1980-1986.

Drug overdose mortality and its economic consequences are explored for ten different drug categories in this article. Data on drug overdose mortality in Texas for the years 1980-1986 are examined and a cost of mortality analysis is presented using the human capital methodology. In addition, mortality rates per 100,000 population are presented for each drug category. The results indicate that the cost of drug overdose mortality has more than doubled over the six-year period. The greatest growth in mortality cost has been for narcotics and cocaine, with commonly prescribed psychoactive drugs remaining fairly constant. The results suggest that men are at far greater risk of drug overdose than women with respect to illicit drugs. Women, however, appear to be at greater risk for overdose from commonly prescribed drugs.

Adult↗
PubMed2004

Importance of tobacco cessation services at higher education public institutions in Texas.

While rates of tobacco use on university campuses rose over the past decade, little is known about what institutions are doing to address this rising concern. Health center directors at public institutions of higher education across the state of Texas were surveyed (n = 42) regarding the perceived importance of smoking cessation, prevalence of interventions on their campuses, and perceived success of intervening efforts. While most health center directors regarded smoking cessation as important, over half of the directors indicated that their sites did not offer tobacco cessation services of any kind. Furthermore, of those offering smoking cessation, most believed that their smoking cessation programs were only somewhat or not at all effective. Findings revealed that there is a noticeable gap between perceived importance and actual implementation of smoking cessation programs within university-based health centers. Recommendations include implementing innovative cessation methods, such as those that are Web-based and highly accessible to students.

Adolescent↗
PubMed1992

Design and conduct of a low-cost mammography screening project: experience of the American Cancer Society, Texas Division.

To improve compliance with recommendations for screening mammography, the American Cancer Society (ACS) Texas Division designed and conducted a media-promoted screening project in 1987. The project was planned during a 2-year period by a task force made up of physicians and lay members of ACS division committees. Radiology centers desiring to participate in the project were asked to submit information about the number of patients they could screen and their equipment, along with physics data, to a review committee. Of 306 facilities that responded, 266 (87%) passed the initial review. Thirteen facilities (4%) submitted images from two examinations using a dedicated mammography phantom, and 27 sites (9%) entered the project by agreeing to adhere to the project standards and guidelines without undergoing formal review. All facilities agreed to provide mammograms for $50 to women scheduling appointments during a 2-week media campaign in February 1987. The project generated 64,459 mammographic screening examinations. Our experience indicates that a media campaign can encourage women to have screening mammograms and that screening facilities will agree to screen a large number of women at reduced cost. This strategy, if widely applied, can improve compliance with mammographic screening recommendations and reduce breast cancer mortality.

Adult↗
PubMed1994

Clinical characteristics of type II diabetic subjects consuming high versus low carbohydrate diets in Mexico City and San Antonio, Texas.

OBJECTIVE: To compare the clinical status of type II diabetic subjects identified in two population-based surveys, one performed in Mexico City, Mexico and the other in San Antonio, Texas. RESEARCH DESIGN AND METHODS: In a low income area of Mexico City, 3,517 age-eligible (35-64 years of age) individuals were randomly selected of whom 3,319 were interviewed at home and 2,198 were examined in a clinic (response rates 62.5%). In San Antonio, 2,357 similarly aged low-income Mexican Americans were randomly selected of whom 2,076 were interviewed at home and 1,511 were examined (response rate 64.1%). Oral glucose tolerance tests were performed at both sites and diabetes was diagnosed according to the World Health Organization (WHO) criteria. In Mexico City, 288 type II diabetic individuals were identified, and 255 were identified in San Antonio. The following variables were measured: height, weight, subscapular and triceps skinfolds, waist-to-hip circumference ratios (WHR), systolic and diastolic blood pressure (random 0 sphygmomanometer), fasting and 2-h postglucose load glucose and insulin concentrations, and fasting total-cholesterol, HDL-cholesterol, and triglyceride (TG) levels. A food frequency questionnaire was used to estimate total calories and the percentage of calories derived from protein, fat, and carbohydrate. Only type II diabetic patients were included in the analyses. Age-adjustment was performed by analysis of covariance for continuous variables and by the Mantel-Haenszel procedure for discrete variables. RESULTS: The mean age, the percentage newly diagnosed cases, and the percentage of males were similar in both sites. The percentage of diabetic patients treated with oral agents was significantly higher in Mexico City (56.9 vs. 72.7% in San Antonio and Mexico City, respectively, P < 0.001), whereas the percentage treated with insulin was significantly higher in San Antonio (18.8 vs. 2.1% for San Antonio and Mexico City, respectively, P < 0.001). A significant difference was observed in the percentage of calories derived from carbohydrate (61.7-63.2 vs. 47.1-47.5% for Mexico City and San Antonio, respectively, P < 0.001) and fat (18.4-20.0 and 30.1-33.0% for Mexico City and San Antonio, respectively, P < 0.001). Body mass index (BMI) was higher in San Antonio (27.6-30.4 vs. 30.2-32.9% for Mexico City and San Antonio, respectively, P < 0.05). Total serum cholesterol was similar at both sites. HDL cholesterol, however, was lower in Mexico City, both in newly and in previously diagnosed patients (30.5-35.8 vs. 39.6-43.3 mg/dl in Mexico City and San Antonio, respectively, P < 0.001). TG levels were higher in Mexico City patients (187-249 vs. 167-179 mg/dl in Mexico City and San Antonio, respectively, P < 0.001). The association between diabetes and the anthropometric and metabolic variables was similar in Mexico City and San Antonio with the following exceptions: Diabetes in Mexico City was associated with less of an elevation in BMI, WHR, and fasting insulin concentration and less of a reduction in the 2-h postoral glucose load insulin concentration compared with diabetes in San Antonio. In addition, although diabetes was associated with a lower HDL in San Antonio subjects, no association appeared between diabetes and HDL in Mexico City subjects. CONCLUSIONS: Diabetic subjects in Mexico City were more likely to be treated with oral agents and less likely to be treated with insulin compared with San Antonio patients. Previously diagnosed diabetic subjects in San Antonio had higher BMIs than diabetic subjects in Mexico City. Diabetic subjects in Mexico City ate less fat but more carbohydrate than those in San Antonio. TG levels were higher and HDL-cholesterol levels were lower in Mexico City diabetic subjects compared with those in San Antonio. San Antonio diabetic subjects had lower HDL levels than nondiabetic subjects but, in Mexico City, HDL levels were similar in diabetic subjects and nondiabetic subjects...

Adult↗
PubMed1997

The treatment of type II diabetes in Texas. Current issues for managed care and employers.

In 1995, a forum was held in Dallas, Texas, to discuss the current state of treatment for type II diabetes and the issues facing managed care organizations (MCOs) and employers. Attendees included representatives from the American Diabetes Association (ADA), diabetologists, medical directors from leading MCOs in the area, benefits managers and employee representatives from large corporations in the region, diabetes educators, and a range of health care personnel directly involved in the care and treatment of patients with type II diabetes. The objectives of the forum were to discuss the state of diabetes treatment from the perspectives of MCOs and employers, to create a better understanding of the issues in treating diabetic patients, and to reach a consensus on the standards of care and the treatment guidelines for managed care patients with diabetes. Several needs were agreed on and identified by the attendees, including the need to develop minimum standards of care for the management of diabetes care, to improve patient and physician education programs and the communication between MCOs and employers, to acquire more sophisticated outcomes data, to pursue aggressive treatment of hyperglycemia, to increase emphasis on managing care to achieve long-term cost savings, and to stress greater patient responsibility for their own care.

Algorithms↗
PubMed1997

Moderate-to-severe diabetic retinopathy is more prevalent in Mexico City than in San Antonio, Texas.

OBJECTIVE: To compare the prevalence of diabetic retinopathy (DR) between low-income Mexicans from Mexico City and Mexican-Americans from San Antonio, Texas. RESEARCH DESIGN AND METHODS: We designed a cross-sectional population-based study in low-income neighborhoods of Mexico City and San Antonio. The men and non-pregnant women included in the study had NIDDM and were between 35 and 64 years of age. Ophthalmologic evaluation was performed in 414 patients, 204 in San Antonio and 210 in Mexico City. Seven field standard stereophotographs of each eye were obtained, adapting the Early Treatment Diabetic Retinopathy Study protocol, and graded at the Fundus Photograph Reading Center of the University of Wisconsin. RESULTS: Early nonproliferative DR occurred in 37 (17.6%) and 39 (19.1%) patients in Mexico City and San Antonio, respectively. Moderate-to-severe nonproliferative DR occurred in 55 (26.2%) and 37 (18.1%) patients in Mexico City and San Antonio, respectively, and proliferative DR occurred in 12 (5.7%) and 7 (3.4%) patients in Mexico City and San Antonio, respectively. Using univariate and multivariate logistic regression analysis with DR as the dependent variable, age, duration of disease, and fasting glucose concentration were positively and significantly associated with retinopathy, whereas city, systolic blood pressure, and other selected metabolic variables were not. We defined moderate-to-severe DR to include the categories of moderate-to-severe nonproliferative and proliferative DR. For this combined category, Mexico City patients with diabetes had a significantly higher prevalence (P < 0.01) than those from San Antonio when analyzed by multiple logistic regression analysis (odds ratio for Mexico City/San Antonio, 1.72; 95% CI 1.10-2.70). CONCLUSIONS: Overall prevalence of DR is similar in both cities. However, moderate-to-severe DR is significantly higher in Mexico City.

Adult↗
PubMed2001

Prevalence and determinants of type 2 diabetes among Filipino-Americans in the Houston, Texas metropolitan statistical area.

OBJECTIVE: The few available studies suggest that Filipino-Americans have an increased risk for developing type 2 diabetes. The purpose of this study was to determine the prevalence of previously diagnosed type 2 diabetes and its major risk factors among Filipino-Americans. RESEARCH DESIGN AND METHODS: A cross-sectional survey was conducted in the Houston, Texas, metropolitan statistical area between September 1998 and March 2000. The convenience sample included 831 Filipino-American participants aged 20-74 years. The major risk factors assessed were age, sex, family history of diabetes, socioeconomic status, obesity (BMI >30), physical inactivity, acculturation, region of birth and, in women, history of gestational diabetes and delivery of a baby weighing > 9 lb. RESULTS: Overall prevalence was estimated to be 16.1% (95% CI 13.5-18.7). Multivariate logistic regression analyses identified independent risk factors: increasing age from ages 35-44 years (odds ratio [OR] 5.6, 95% CI 1.5-20.5) to 65-74 years (34.2, 7.2-163.0); male sex (1.8, 1.1-32.1); family history of diabetes (4.7, 2.6-8.5); obesity (3.6, 1.4-9.0); region of birth, Mindanao (3.2, 1.3-7.7); and, among women, gestational diabetes (21.7, 6.7-69.7) and low income (5.3, 1.4-20.2). CONCLUSIONS: The study observed a high prevalence of type 2 diabetes and supports earlier studies suggesting that Filipinos are at higher risk for type 2 diabetes than the U.S. non-Hispanic white population.

Adult↗
PubMed2001

Elevated incidence of type 2 diabetes in San Antonio, Texas, compared with that of Mexico City, Mexico.

OBJECTIVE: To compare the incidence of type 2 diabetes between low-income Mexican-Americans residing in San Antonio, Texas, and low-income residents in Mexico City, Mexico. RESEARCH DESIGN AND METHODS: Using data from the San Antonio Heart Study and the Mexico City Diabetes Study, we compared the incidence of type 2 diabetes in 35- to 64-year-old low-income Mexican-American residents of San Antonio with similarly aged low-income residents of Mexico City. Because of the different follow-up times in the two studies, Poisson regression was used to compare the rates of diabetes. Potential risk factors for diabetes were also analyzed to determine whether they explained or contributed to a difference in incidence. RESULTS: The age- and sex-adjusted incidence of type 2 diabetes was significantly higher in San Antonio (RR 2.01) compared with Mexico City. This difference was seen primarily in the oldest age group (55-64 years of age) and remained statistically significant after adjusting for a number of diabetes risk factors, including demographic, anthropometric, and metabolic variables. Follow-up rates were similar in both cities. CONCLUSIONS: We conclude that there was a higher incidence of type 2 diabetes in San Antonio than in Mexico City, and that difference occurred primarily in individuals in the oldest age group. The potential mediating factors we examined did not account for this difference. Other factors, such as exercise and diet, which were not available for analysis in this study, in addition to a cohort effect, may have contributed to the difference in incidence of type 2 diabetes in the two cities. In addition, there was no evidence of a higher case fatality among diabetic individuals from Mexico City compared with San Antonio.

Adult↗
PubMed2005

Familial aggregation of severity of diabetic retinopathy in Mexican Americans from Starr County, Texas.

OBJECTIVE: Diabetic retinopathy is a major cause of blindness. To determine whether retinopathy itself or only its severity aggregates in families, we examined the occurrence and severity of diabetic retinopathy in Mexican-American siblings with type 2 diabetes. RESEARCH DESIGN AND METHODS: Using stereoscopic fundus photography of seven standard fields, we measured retinopathy in 656 type 2 diabetic patients from 282 Mexican-American families from Starr County, Texas. Retinopathy severity was scored using the Early Treatment of Diabetic Retinopathy Study system and classified as no retinopathy, early nonproliferative diabetic retinopathy (NPDR-E), moderate-to-severe nonproliferative diabetic retinopathy (NPDR-S), or proliferative diabetic retinopathy (PDR). RESULTS: Of 249 siblings of randomly selected probands with retinopathy, 169 (67.9%) had retinopathy, compared with 95 of 125 siblings of unaffected probands (76.0%; P = 0.11). Proband retinopathy class was associated (P = 0.03) with sibling retinopathy class, with significant odds ratios (ORs) for NPDR-E versus no retinopathy (OR 0.57 [95% CI 0.35-0.93]) and PDR versus NPDR-E (2.02 [1.13-3.63]); the contrast of NPDR-S versus NPDR-E approached significance (1.78 [0.99-3.20]). With the more severe classes (PDR and NPDR-S) combined in one group and the less severe ones (none and NPDR-E) in another, more severe proband retinopathy was associated with more severe sibling retinopathy (1.72 [1.03-2.88]). CONCLUSIONS: More severe diabetic retinopathy showed evidence of familial aggregation, but the occurrence of diabetic retinopathy per se did not. The factors involved in the onset of diabetic retinopathy may differ from those involved in its progression to more severe forms.

Aged↗
PubMed2001

Postexposure rabies prophylaxis protocol for domestic animals and epidemiologic characteristics of rabies vaccination failures in Texas: 1995-1999.

OBJECTIVE: To determine whether postexposure rabies prophylaxis (PEP) in domestic animals, as mandated by the state of Texas, has continued to be effective and to evaluate PEP and preexposure rabies vaccination failures from 1995 through 1999. DESIGN: Retrospective study. ANIMALS: 830 unvaccinated domestic animals (621 dogs, 78 horses, 71 cats, and 60 cattle) that received PEP and 4 animals (3 dogs and 1 horse) that had preexposure rabies vaccination failure. PROCEDURE: Zoonotic incident case reports from 1995 through 1999 were reviewed for information regarding unvaccinated domestic animals that received PEP according to state protocol after exposure to a rabid animal; reports were also reviewed for information regarding preexposure rabies vaccination failures. The PEP recommendations were to immediately vaccinate the animal against rabies, isolate the animal for 90 days, and administer booster vaccinations during the third and eighth weeks of the isolation period. Rabies vaccines used in the PEP protocol were administered via the route prescribed by the USDA. RESULTS: From 1995 through 1999, 830 animals received PEP; 4 failures were recorded. Additionally, 4 preexposure rabies vaccination failures were recorded. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study indicate that an effective PEP protocol for unvaccinated domestic animals exposed to rabies includes immediate vaccination against rabies, a strict isolation period of 90 days, and administration of booster vaccinations during the third and eighth weeks of the isolation period. This PEP schedule has proven to be effective for control of rabies in domestic animals.

Animals↗
PubMed1995

Age, ethnic and gender differences in physical fitness of middle-school children in east Texas.

This research studied the health-related physical fitness status of boys and girls in Grades 5 and 6 in a rural school district in East Texas in an examination of possible age, ethnic, and gender differences. A three-way multivariate analysis of variance was conducted with gender, ethnicity, and age as the independent variables and nine physical measurements as the dependent variables. Height was the most important discriminating physical measurement, with girls significantly taller than boys at ages 10 and 11 and with boys significantly taller than girls at age 13. Canonical discriminant function separated black children from both Caucasian and Hispanic children in height, weight, mile run, systolic blood pressure, and diastolic blood pressure.

Adolescent↗