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PubMed2001

The health risk of hypertension in south Texas: a demographic profile.

This article provides a demographic profile of the hypertensive adult in South Texas. Hypertension, a silent disease because of its lack of overt signs and symptoms, poses a major public health problem. Few prevalence studies have been completed reflecting Mexican-American populations. South Texas hypertension trends are comparable to national trends. However, the awareness of hypertension in South Texas is lower than that of the national population. The density of risk factors may be responsible for the patterns of South Texas hypertension.

Adult↗
PubMed1975

Comparative survey of psychiatrists' prescription preferences: New York and Texas.

The present survey compares the treatment preferences of New York and Texas psychiatrists using a questionnaire report of a single psychiatric case. The characteristics of this approach enable the investigator to hold and symptoms and syndromes of the patient constant. All clinicians respond to identical stimuli. What varies naturally, then, is the judgment of the clinician in developing his treatment procedure, thereby enabling estimation of the degree of standardization in treatment preferences. Three hundred twelve psychiatrists from New York and 133 from Texas provided data for comparative purposes. On the first admission 41% of the New York respondents and 24% of the Texas psychiatrists preferred a regimen that included more than one drug. When a combination of drugs was selected, chlorpromazine-trifluoperazine was preferred. But ten other specific combinations also were selected. Most were of potent neuroleptics, but some included antidepressant-neuroleptic combinations. None of the variables included in the study provided tangible systematic variance for these treatment preferences. A year and a half after first admission, followed by treatment in and out of hospital, the patient's clinical course continued to deteriorate. At this point more than 50% of the respondents in each state selected a regimen that included a minimum of two drugs. As many as 24 different combinations were selected for this single case. Nineteen percent of the New York respondents and 13% of the Texas respondents selected a regimen that included three or more psychoactive medications. The existence of these treatment preferences requires a more basic understanding of treatment preferences, for these seems to be no basis for them.

Adolescent↗
PubMed1984

Selenium availability in Texas: possible clinical significance.

In light of recent reports that have indicated that selenium is an essential micronutrient and possible natural cancer inhibitor, data on the geographic distributions of selenium in Texas were gathered and compared with the distribution of age-adjusted cancer mortality rates. We considered concentrations of selenium measured in ground and surface water to be indicators of its presence in rocks, soil, and locally grown crops. Texas water sources were found to be poor in selenium, except for the Panhandle and the West Texas regions, where soil consists of erosion products from the selenium-rich Rocky Mountains. In general, lower cancer mortality was observed for the selenium-rich regions of Texas compared with cancer mortality for the selenium-poor regions. Even though the risks from cancer-provoking factors also differed geographically, the observed pattern was sufficiently suggestive to warrant further attention to selenium.

Female↗
PubMed1998

Assessing the burden of cancer in Texas using vital statistics data.

BACKGROUND: Vital statistics data were used to describe the burden of cancer in Texas. METHODS: Average annual age-adjusted mortality data in Texas (1986 to 1990) for 17 cancer types were compared with the US data for whites and blacks and with California data for Hispanics. Trends were examined from 1980 to 1990 for the entire state and from 1976 to 1989 for 24 geographic regions within the state. RESULTS: Mortality excesses were detected for lung and liver cancer, and deficits for colorectal, breast, and prostate cancers. Rates were generally stable from 1980 to 1990 with several exceptions (lung, liver, colon). Six areas of Texas, including four areas along the Gulf Coast, had relatively more excesses of various cancers, without a discernible pattern by cancer type. CONCLUSIONS: Overall, Texas has fared favorably in cancer mortality when compared with the United States. Enhanced evaluation of the frequency of cancer, as well as the conduct of etiologic research, must await the availability of statewide long-term cancer incidence data.

Black or African American↗
PubMed2005

The Texas Training Initiative for Emergency Response (T-TIER): an effective learning strategy to prepare the broader audience of health professionals.

Recognizing the need to prepare the broader workforce of responders to plan and respond to the consequences of public health emergencies, the School of Rural Public Health at Texas A&M University Health Science Center launched a self-supporting, continuing education initiative in March 2003, designed to offer training to individuals throughout Texas with responsibility for emergency planning, preparedness, and response. The Texas Training Initiative for Emergency Response (T-TIER) fosters the integration and collaboration of key organizations and disciplines, using the Centers for Disease Control and Prevention-identified competencies by focus area. T-TIER is designed as a three-module training initiative that builds upon the knowledge, skills, and abilities that participants acquire in each preceding module. To increase efficacy, T-TIER uses multiple training methodologies, including live presentations, hands-on practical activities, tabletop exercises, and on-site or televideo conference technology. This unique, multidisciplinary approach enhances respect and collaboration among the various disciplines, limiting unilateral emergency preparedness planning and response at the national, state, and local levels. The next step in disseminating this training curriculum is the adaptation of materials using distance education technologies to reach a broader audience, both in Texas and other states across the nation.

Bioterrorism↗
PubMed2004

An ancient bottleneck in the Lost Pines of central Texas.

The retreating edge hypothesis for species responding to climate change predicts severe bottlenecks and eventual extinction. The disjunct Lost Pines population at the westernmost edge of the widespread Pinus taeda range is well suited for testing this prediction. The occurrence of one or more genetic bottlenecks in the Lost Pines population was tested using 34 nuclear microsatellite markers and a control sample from the larger, more continuous east Texas P. taeda forests. The Lost Pines population has undergone drastic contractions in effective population size between 3000 and 30 000 years bp. These results were supported by: (i) detection of transient heterozygosity excess, (ii) a mode-shift indicator of allele frequencies, and (iii) a ratio of allele number to allele size range. No bottleneck was detected for the east Texas control using any of the three methods. The distribution of allele frequencies was skewed for the Lost Pines population compared to the control, indicating a loss of rare alleles. However, allelic diversity was similar between the Lost Pines population and its east Texas control; the mean allele number per locus was 5.29 and 5.38, respectively. It is proposed that the Lost Pines population was the western refugium for P. taeda during Pleistocene glaciation and that East Texas P. taeda forests descended from the bottlenecked Lost Pines population.

Climate↗
PubMed2006

Phylogeny and biogeography of Croton alabamensis (Euphorbiaceae), a rare shrub from Texas and Alabama, using DNA sequence and AFLP data.

Croton alabamensis (Euphorbiaceae s.s.) is a rare plant species known from several populations in Texas and Alabama that have been assigned to var. texensis and var. alabamensis, respectively. We performed maximum parsimony, maximum likelihood, and Bayesian analyses of DNA sequences from the nuclear ribosomal internal transcribed spacer (ITS) and 5.8S regions and chloroplast trnL-trnF regions from collections of the two varieties of C. alabamensis and from outgroup taxa. C. alabamensis emerges alone on a long branch that is sister to Croton section Corylocroton and the Cuban endemic genus Moacroton. Molecular clock analysis estimates the split of C. alabamensis from its closest relatives in sect. Corylocroton at 41 million years ago, whereas the split of the two varieties of C. alabamensis occurred sometime in the Quaternary. Amplified fragment length polymorphism (AFLP) analyses were performed using two selective primer pairs on a larger sampling of accessions (22 from Texas, 17 from Alabama) to further discriminate phylogenetic structure and quantify genetic diversity. Using both neighbour joining and minimum evolution, the populations from the Cahaba and Black Warrior watersheds in Alabama form two well-separated groups, and in Texas, geographically distinct populations are recovered from Fort Hood, Balcones Canyonlands, and Pace Bend Park. Most of the molecular variance is accounted for by variance within populations. Approximately equal variance is found among populations within states and between states (varieties). Genetic distance between the Texas populations is significantly less than genetic distance between the Alabama populations. Both sequence and AFLP data support the same relationships between the varieties of C. alabamensis and their outgroup, while the AFLP data provide better resolution among the different geographical regions where C. alabamensis occurs. The conservation implications of these findings are discussed.

Alabama↗
PubMed2004

Nonphysician practice of dermatologic surgery: the Texas perspective.

BACKGROUND: Increases in complications resulting from the nonphysician practice of dermatologic procedures have been reported nationally. This investigation was initiated owing to growing concern regarding the nonphysician practice of medicine in Texas. OBJECTIVE: The objective was to survey dermatologists in Texas to determine the number of patients seeking corrective treatment owing to complications from dermatologic procedures performed by nonphysicians. METHODS: A total of 488 dermatologists in Texas were surveyed and seven patients who experienced complications were interviewed by phone. RESULTS: Nearly 53% of responding physicians noted increased complications resulting from nonphysician practice of medicine. Approximately 33% of responding physicians reported that complications were known to have occurred in the absence of an on-site supervising physician. CONCLUSION: The increase in the number of complications owing to nonphysician practice of medicine in Texas mirrors the increases that have been reported nationally. The serious complications reported underscore the need for improved awareness and regulatory changes by state boards of medicine.

Clinical Competence↗
PubMed1990

Rickettsia in Texas.

Since the first reported case in 1941, Rocky Mountain spotted fever in humans has been reported from many areas of Texas, with two major foci, one located in the north-central region and the other in the eastern region of the state. During the period 1979-1988, 421 cases of RMSF were reported, reaching 108 cases in 1983 and declining in subsequent years. Statewide surveillance programs to detect spotted fever group rickettsiae in tick populations were initiated in 1976. In recent years, the SFG infectivity rates in these tick species have included Dermacentor variabilis, 5.2%; Amblyomma americanum, 7.1%; Rhipicephalus sanguineus, 2.9%; and Ixodes scapularis, 10.2%. Further determination of involved rickettsial species and pathogenicity is needed, as many of these specimens are collected from humans and during epidemiological investigations. Various foci of murine typhus occur in Texas. During 1979-1988, 400 human cases were reported. The majority of cases occurred in people who resided in south Texas. Several investigations have shown a possible link between typhus infections and exposure to Ctenocephalides felis. Other rickettsial infections currently reported in Texas include Q fever and ehrlichiosis.

Animals↗
PubMed1987

Suicide in Texas: a cohort analysis of trends in suicide rates, 1945-1980.

Recent clusters of teenage suicides in Texas suburban communities have focused national attention on the rise in teenage suicidal behavior. This study sought to clarify the teenage suicide phenomenon by using a cohort method of data analysis. Beginning with suicide rates for white males aged 15-19 in 1945, suicide rates were calculated and plotted for each 5-year age cohort entering the late teenage years, when suicide risk factors dramatically increase. Our analysis of these cohort patterns confirmed the ever-rising risk factor associated with the ages of 15-19. This trend is consistent with many studies suggesting that teenage suicide is a function of socioeconomic and psychological factors operating across community and national boundaries. In addition, our study revealed that as white males 15-19 years of age in 1945 aged, their suicide rates also increased, confirming earlier findings that the suicide risk factor increases with age. In fact, Texas data for 1980 revealed that older persons, not teenagers, had the highest suicide rates-a finding that confirms other studies' results. Finally, Texas cohort patterns for suicide revealed the recent curvilinearity tendencies of older adult male suicide rates. By 1980 Texas data revealed a bimodal distribution of high suicide risk, with white males in their late 20s and ages 55 and over having the highest rates.

Adolescent↗
PubMedDate not supplied

Frequency of prenatal diagnosis of birth defects in Houston, Galveston and the Lower Rio Grande Valley, Texas 1995.

BACKGROUND: Estimates of the proportion of birth defects diagnosed before birth exist for only a few types of birth defects and for a few geographic regions in the United States. This population-based study examines rates of prenatal diagnosis for previously unstudied birth defects in a new geographic region. METHODS: Active surveillance of 23 categories of birth defects among 111,902 infants born in 77 birthing hospitals in Texas in 1995 identified 852 infants or fetuses with major birth defects. Surveillance was conducted by the Texas Birth Defects Monitoring Program of the Texas Department of Health. Two regions were covered, the Houston/Galveston metropolitan area as well as the Lower Rio Grande Valley of Texas. Rates of prenatal diagnosis were evaluated for 23 different types of birth defects, using proportions and 95% confidence intervals. RESULTS: One third of the 852 infants or fetuses with birth defects were prenatally diagnosed. Diagnosis rates varied greatly depending on the type of birth defects and were lower among infants born to Black and Hispanic women. More than 60% of anencephaly, encephalocele, gastroschisis and trisomies 13 and 18 were diagnosed antenatally. Many of the fetuses that were electively terminated had birth defects or combinations of birth defects that were potentially lethal. Prevalence rates for birth defects generally do not include fetuses that die or are electively terminated before 20 weeks of gestation. Thus, 36% of anencephaly, 21% of omphalocele, 15% of encephalocele and between 7 and 10% of spina bifida, hydrocephaly, renal agenesis, and trisomies 13, 18, and 21 were not included in our published rates. CONCLUSIONS: Published rates for specific types of birth defects are spuriously low. This should be considered when investigating alleged clusters and comparing rates of birth defects across geographic areas. Since many elective abortions are for lethal or potentially lethal birth defects, a major effect of prenatal diagnosis is the resultant decrease in infant mortality attributable to birth defects.

Abortion, Induced↗
PubMed1997

African Americans and women have the highest stroke mortality in Texas.

BACKGROUND AND PURPOSE: Hispanic American (HA), African American (AA), and non-Hispanic white (NHW) populations are well represented in Texas. The Texas HA population is 95% Mexican American, affording comparison with other Hispanic populations. From risk factor profiles we expected stroke mortality to be highest in AAs and HAs. We also expected stroke mortality to be considerably higher for men than for women based on previous data. METHODS: We used International Classification of Diseases, 9th Revision, codes 430 to 438 to search Texas vital statistics data for the 5-year period from 1988 through 1992. Race/ethnic differences are presented in age- and sex-specific format to avoid masking the important interaction of age and sex with stroke mortality. RESULTS: Women constituted 61% of the 40,346 stroke deaths in Texas during this period. The ratio of stroke deaths for women versus men approximates the ratio of women to men in the population. AAs had a threefold to fourfold increased stroke mortality relative to NHWs at young ages. At older ages, when stroke mortality is the highest, the stroke mortality rate in NHWs approached the stroke mortality rate of AAs. HAs had a significantly higher rate of stroke mortality at younger ages relative to NHWs but a significantly lower rate at older ages. CONCLUSIONS: Measures to prevent stroke mortality should emphasize its predilection for young AAs and women. A rigorous surveillance project is needed to determine whether stroke mortality is underestimated in the HA population.

Black or African American↗
PubMed2003

Embracing the local: enriching scientific research, education, and outreach on the Texas-Mexico border through a participatory action research partnership.

Cameron Park, Texas, is a colonia (an isolated, unincorporated rural settlement without municipal improvements) on the Texas-Mexico border in the Lower Rio Grande Valley, in Cameron County near Brownsville, Texas. Cameron Park has a population of 5,961 residents, 99.3% of whom are Hispanic. The annual median income is 16,934 US dollars, about one-half of the state median. Fifty-eight percent of families generally and 68% of those with children younger than 5 years have incomes below poverty level. Cameron Park resides geographically in a region where agriculture has been, and continues to be, a dominant industry, a fact consistent with the intensive use of pesticides and increased potential for air, water, and ground contamination. The practice of good environmental health is extremely difficult under these conditions. In 1999 the Texas A&M University Center for Housing and Urban Development's Colonias Program and the Center for Environmental and Rural Health teamed up to create an environmental health education and outreach program called the Cameron Park Project (CPP). The CPP focused on how to reduce potential environmental exposures associated with human illness by providing residents with scientifically sound information on positive health practices and how to deal with environmental hazards. In this article we discuss the research methodology used in the CPP, a methodology specifically chosen to address four challenges presented by colonias to conducting valid and reliable research.

Community-Institutional Relations↗
PubMed2005

Pesticide safety training and access to field sanitation among migrant farmworker mothers from Starr County, Texas.

Very little published research describes employer compliance with EPA-mandated Worker Protection Standard (WPS) pesticide safety training and the OSHA Field Sanitation Standard among farmworker women in general and mothers specifically. A goal of both standards is limiting farmworkers' exposure to potentially hazardous agricultural pesticides. Data from a NIOSH-supported cohort study ("Injury and Illness Surveillance in Migrant Farmworker Families") allowed for examining these issues. The cohort included 267 migrant farmworker families who usually reside along the Texas-Mexico border (Starr County, Texas). Data were collected in Starr County during in-home interviews. Of 102 mothers who participated in migrant farm work during summer 2001, 57 (55.9%) reported having ever received training/instruction in the safe use of pesticides, while 47 (46.1%) reported having received training within the previous five years, as required by WPS. Of trained mothers, 91.5% to 93.6% reported that their training covered key WPS areas: (1) entry into a recently treated field, (2) pesticide related injuries/illnesses, and (3) where to go and who to contact for emergency care following exposure. Regarding access to field sanitation, 67.5% to 84.2% of 77 mothers who worked outside Texas reported employer-provided decontamination supplies (e.g., soap, wash water, towels, and toilet facilities). However, a strikingly smaller proportion (12% to 28%) of 25 mothers who worked within Texas reported access to the same resources, suggesting discrepancies in compliance across the U.S. Due to the low level of employer compliance with both WPS and OSHA mandated standards, increased enforcement and an alternate delivery of pesticide training is recommended.

Accident Prevention↗
PubMed1990

Reading, writing and the Texas supplement to the essential elements for the hearing impaired.

Students need educational programs which foster maximum development of their personal knowledge, skill, and competence. To accomplish this, they should have access to a well-balanced curriculum, effective instruction and opportunities to succeed. In accordance with this philosophy, the 67th and 68th Legislatures of the State of Texas (1981-1984) established rules and procedures for the implementation of a state basic curriculum. Under this mandate, school districts are required to implement the provisions of these rules in "a manner which will enable all students to participate actively in a well-balanced curriculum and master, to the best of their ability, the knowledge, skills, and competencies established through the essential elements," in order to become accredited by the Texas Education Agency. To meet these requirements and make the goals wholly appropriate for hearing-impaired students in Texas, the Division of Services for the Deaf of the Texas Education Agency developed an in-depth expansion of these state-mandated essential elements in the area of English Language Arts, grades K-8. This expansion, the Supplement to the Essential Elements for the Hearing Impaired (SEE-HI) includes the original language arts essential elements as well as supplemental goals and sub-goals necessary for students who have language deficiencies, especially those caused by hearing loss.

Accreditation↗
PubMed1985

Human cutaneous leishmaniasis acquired in Texas.

Four cases of autochthonous human cutaneous leishmaniasis have been identified in south-central Texas since 1980. The patients presented with chronic ulcerating papules on the face, earlobe, and lateral thigh. In two patients, the infections healed without treatment. In the other two patients, the lesions healed following treatment with intramuscular sodium stibogluconate or topical antimony potassium tartrate. Serologic testing of family members, using four different techniques, indicates that asymptomatic infections may occur. These are the first reported cases of cutaneous leishmaniasis acquired in Texas since 1974. Organisms isolated from patients in 1974 and 1980 belonged to the Leishmania mexicana complex when tested by the isoenzyme technique. Although no animal reservoir or insect vector has been identified, six species of sand flies belonging to the genus Lutzomyia do inhibit this part of Texas. Accumulated evidence strongly suggests that cutaneous leishmaniasis is endemic in south-central Texas.

Antibodies↗
PubMed1996

Leishmaniasis in Texas: epidemiology and clinical aspects of human cases.

Twenty-seven autochthonous cases of cutaneous leishmaniasis in Texas were identified by contact with dermatologists and State Health Department officials, and by a review of medical records, pathology reports, and previously published case reports. Fifteen cases were previously unreported. Although the date of onset of the first recognized case was 1903, in 20 of the cases the date of onset of the lesion(s) was in 1980-1989. Twelve cases were female; 15 were male. Age at diagnosis ranged from two to 86 (median 37) years. The disease was identified significantly more frequently in younger males and older females. The distribution of cases closely followed the distribution of Neotoma micropus, a rodent host for Leishmania mexicana. The most common risk factor appeared to be residence or activity in close proximity to woodrat habitat. Two cases lived in central Texas; the remainder had a residence in, or history of travel to, southern Texas. A majority of cases were first recognized during the cooler months of the year. Most lesions began as papules or nodules that subsequently ulcerated. In 20 cases, a single lesion was present. Five cases had resolution of their lesions without receiving specific anti-leishmanial therapy; lesions of 17 resolved after treatment with a variety of therapies. One life-long case of disseminated disease failed to respond to treatment, and four cases were lost to follow-up. A Leishmania-specific lymphocyte proliferation assay gave a positive response for four of five cases tested. Screening of 13 family members found no evidence of subclinical infection. These 27 cases, and two recently recognized cases reported in a note added in proof, indicate that cutaneous leishmaniasis may be more common in Texas than previously thought.

Adolescent↗
PubMed2005

Naturally occurring secondary nutritional hyperparathyroidism in cattle egrets (Bubulcus ibis) from central Texas.

Naturally occurring secondary nutritional hyperparathyroidism is described in the nestlings of two colonies of cattle egrets (Bubulcus ibis) from Central Texas (Bryan and San Antonio, Texas, USA). Nestlings from a third colony (Waco, Texas, USA) were collected in a subsequent year for comparison. Birds from the first two colonies consistently had severe osteopenia and associated curving deformities and folding fractures of their long bones. These birds also had reduced bone ash, increased osteoclasia, a marked decrease in osteoblast activity, variable lengthening and shortening of the hypertrophic zone of the epiphyseal cartilage, decreased and disorganized formation of new bone, and a marked hypertrophy and hyperplasia of the parathyroid glands as compared to birds collected from the third colony. Fibrous osteodystrophy was found in all of the birds from San Antonio and Bryan. Evidence of moderate to severe calcium deficiency was also identified in 33% of the cattle egrets collected from Waco. Gut contents of affected chicks contained predominately grasshoppers and crickets; vertebrate prey items were absent from the Bryan birds. Grasshoppers and crickets collected from fields frequented by the adult egrets in 1994 had 0.12-0.28% calcium and 0.76-0.81% phosphorus. Pooled grasshoppers and crickets collected during a subsequent wet early spring averaged 0.24% calcium and 0.65% phosphorus. Although the phosphorus content of the insect prey was adequate for growth, calcium was approximately one-third the minimum calcium requirement needed for growth for other species of birds. It was postulated that cattle egrets breeding in Central Texas have expanded their range into habitat that contains less vertebrate prey, and as a result, many nestling egrets are being fed diets that contain suboptimal calcium. Therefore, in years where vertebrate prey is scarce and forage for insect prey is reduced in calcium, nestling egrets are at risk for developing secondary nutritional hyperparathyroidism.

Animal Nutritional Physiological Phenomena↗