School of Public Health
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Browsing School of Public Health by Author "Antonio A. Rene"
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Item A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas(2000-05-01) Williams, Vanessa P.; Antonio A. Rene; Thomas J. Fairchild; Sally BlakleyWilliams, Vanessa P., A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas. Master of Public Health (Epidemiology), May 2000, 55 pp., 11 tables, 9 figures, references, 52 titles. The cancer experience of Texans differs substantially by race/ethnicity. Among Caucasian, African American, and Hispanic men and women, colon cancer is either the second or third leading type of cancers among Texans. The distribution of time to death over a six-year period were assessed from a cohort of African American, Hispanic, and Caucasian men and women diagnosed with colon cancer in 1992. The purpose of this study is to determine if there is a difference in the overall death time distribution and tumor histology among African Americans, Hispanics, and Caucasian men and women who were diagnosed with colon cancer in 1992 in the state of Texas. Analysis results indicated that Hispanic females (65.59%) and Caucasian males (65.52%) had higher survival times among the race/ethnic groups. African American males (53.85%) and females (56.40%) experienced lower survival time for the cohort. For overall distribution of time to death among deceased subjects, African American males and Hispanic females experienced the lowest distribution times among the subjects. The overall distribution of time to death for all histology types were the same for each type.Item Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas(2005-08-01) Chaudhary, Prateek; Kristine Lykens; Julian Borejdo; Antonio A. ReneChaudhary, Prateek. Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas. Master of Public Health, August 2005, 52 pp, 6 tables, bibliography. The mismanagement of diabetes care, due to disparities in access, deficiencies in health insurance, or poor quality of primary care, can lead to preventable microvascular complications which force diabetics to utilize hospital emergency departments (ED). This study uses 2002 hospital discharge data from the Texas Health Care Information Collection to determine whether diabetic and elderly (65+) African Americans and Hispanics from Texas counties with a low ratio of physicians per, 1,000 population (PPR) are more likely to be admitted through the ED with complications from diabetes. Findings indicate that while Hispanic ethnicity is significantly associated with ED use as a source of admission, diabetics from counties with higher PPR are more likely to be admitted through the ED for diabetes complications than diabetics from counties with a lower PPR.Item An Analysis of Osteoporosis-Related Hip Fractures, Using Hospital Discharge Data(2001-12-01) Rubin, Bernard; Antonio A. Rene; Douglas Mains; Muriel MarshallThe purpose of this study is to assess whether a current physician practice may inadequately diagnose osteoporosis in a high risk population of postmenopausal women who have sustained a hip fracture. A review of all patients discharged from Texas hospitals during calendar year 1999 was analyzed, using the Public Use Data File provided through the Texas Health Care Information Council. A total of 13,628 women over the age of 55 were admitted to hospital with a fractured hip. Only 2,233, or 16.3%, of women were also coded with the diagnosis of osteoporosis (P [less than] 0.001). Forty to fifty percent of postmenopausal women have osteoporosis. Therefore, women presenting with a fragility fracture form an even more at-risk subset of the population, such that one would expect a majority of these women to carry a diagnosis of osteoporosis. Percentages of Caucasian, non-Hispanic women in each group were comparable. The age distribution in each group was comparable, implying that the coded diagnosis of osteoporosis was not related to the age of the women when admitted to the hospital. In conclusion, physicians practicing in Texas during calendar year 1999 inadequately diagnosed osteoporosis in a high risk population of postmenopausal women who were admitted to hospital with fractured hip. Future analysis of subsequent analysis databases will be able to identify whether or not continuing medical education efforts will cause physicians to diagnose osteoporosis in this high risk population more frequently.Item Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, ACLS 1970-1994(1999-12-01) Braun, LeeAnn; Sally Blakley; Antonio A. ReneBraun, LeeAnn, Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, Aerobics Center Longitudinal Study, 1970-1994. Master of Public Health (Epidemiology), December, 1999, 44 p.p., 9 tables, references, 24 titles. Cardiorespiratory fitness and body mass index are related to morbidity and mortality (Manson, 1996). There is a preponderance of evidence supporting this relation in men (Gibbons, 1983; Blair, 1989, 1995, 1996; Lee, I, 1993; Barlow, 1995; Kampert, 1996; Dorn, 1997; Lee, C, 1999). The evaluation of the stated risk factors have been virtually unexplored in a cohort of women. The aim of this study is to evaluate whether higher levels of cardiorespiratory fitness attenuate the risk of all-cause mortality in overweight and obese women. In this prospective study, the study population consisted of 7572 women ages 20-89 years, who had a medical examination and achieved at least 85% of their age-adjusted maximal heart rate during a maximal treadmill test were followed for 69,979 woman-years. After adjustment for age, exam year, health status and smoking status, unfit women had a higher risk for all-cause mortality across BMI categories [RR 1.70 95% CI (1.18, 2.43)]. The benefits of cardiorespiratory fitness significantly decrease the risk of all-cause mortality in women as the concurrent consideration of cardiorespiratory fitness.Item Defining the Prostate Cancer Population in Texas Using Hospital Discharge Data(2004-05-01) Manuel, Christopher J.; Karan Singh; Antonio A. ReneManuel, Christopher J., Defining the prostate cancer population in Texas using hospital discharge data. Masters of Public Health (Biostatistics), May 2004, 25 pp., 6 tables, bibliography, 35 titles. The Texas Health Care Information Council (THCIC) was created by the 74th Texas Legislature in 1995. THCIC’s primary purpose is to provide data that will enable Texas consumers and health plan purchasers to make informed health care decisions. This data also serves the purpose of providing information about disease trends and hospital discharges. The purpose of this study was to describe the disease status of prostate cancer in the state of Texas. Prostate cancer is the most common non-cutaneous male malignancy and ranks as the second cause of cancer-related mortality among men in the United States. Epidemiologic data was extracted from the data set for analysis looking at disease trends based on a variety of factors such as age, race, and insurance.Item Descriptive Study of Non-Fatal Occupational Injuries Treated in the Emergency Department(2001-12-01) Sinha, Sony; Antonio A. ReneSinha, Sony, Descriptive Study of Non-Fatal Occupational Injuries Treated in the Emergency Department. Master of Public Health (Epidemiology), December, 2001, 18 pp., 10 tables, 6 titles. This study describes work-related injury visits to the emergency department. The data used for this study was the 1999 National Hospital Ambulatory Medical Care Survey emergency department subsection. The patterns of work-related injury visits by month, day of the week, gender, race/ethnicity, age, primary diagnosis and primary cause of injury are examined. The most common diagnoses for work-related injuries were sprains and strains, open wounds, and superficial injuries (71% of total visits). The Most common causes of work-related injuries were sharp objects, overexertion, being struck, and falls (69% of total visits).Item Firefighter Fatality Retrospective Study: A Comparison Between Career and Volunteer Firefighters(2004-05-01) Brackett, Benjamin Earl; Sharon Clark; Antonio A. Rene; Karan SinghBrackett, Benjamin Earl, Firefighter Fatality Retrospective Study: A Comparison Between Career and Volunteer Firefighters. Masters of Public Health (Epidemiology), May 2004, 21 pp., 9 tables, References. A 13-year retrospective study comparing the relative risk of career firefighters dying on the job in relation to the relative risk of volunteer firefighters dying on the job. This paper sought to determine if there was a significant difference between overall career and volunteer firefighter fatalities, as well as any differences among several variables. It was determined that there is no statistical difference between the fatality rates of career and volunteer firefighters. However, a number of statistically significant differences were identified when examining specific variables such as nature of fatal injury, fixed property use, and activity being performed at time of death.Item Race/Hispanicity and Use of Alcohol and Illicit Drugs in the United States Construction Industry(2004-05-01) Rosario-Rosado, Rosa V.; Antonio A. Rene; Sharon Clark; Karan SinghRosario-Rosado, Rosa V., M.S. Race/Hispanicity and Use of Alcohol and Illicit Drugs in the United States Construction Industry. Doctor of Public Health (Epidemiology), May 2004, 135 pp., 19 tables, bibliography, 49 Titles. This study explored the 2001 National Household Survey on Drug Abuse’s data in order to identify any difference in the patterns of substance use among different groups represented in the national construction industry. The study included male, 18 years and older, self-classified as U.S.-born non-Hispanic Whites, U.S.-born non-Hispanic African Americans, U.S.-born Hispanics or immigrant Hispanics with different lengths of stay in the U.S. (less than five years; five years to less than 10 years; and 10 or more years), that indicated working in the construction industry. Substances of interest were alcohol, marijuana, cocaine, crack, heroin, hallucinogens, inhalants, and psychotherapeutics. Differences by race/hispanicity in substance use were found. Immigrant Hispanics living in the U.S. for less than five years were significantly (p [less than] .0001) less likely to use substances as compared to other groups. Immigrant Hispanics with five to less than 10 years and those with 10 or more years living in the U.S. were 1.096 (95% CL = 1.079 to 1.112) and 1.160 (95% CL= 1.146 to 1.175) times more likely to use any illicit drug during past year, respectively, when compared with U.S.-born Hispanics. Characteristics associated with the past year and the past month use of substances were: working for a small company, missing two or more whole days of work due to sickness or injury, and skipping three or more days of work. Findings of this study suggest that, when designing substance use and abuse prevention programs, it is not only important to take into consideration differences by race/hispanicity, but that the length of stay in the U.S. also can affect the substance use behaviors of immigrant construction workers.Item The Association Between Medical Insurance Coverage, In-Hospital Case Fatality Rate, and Length of Hospital Stay Following Admission for Acute Myocardial Infarction in Texas Hospitals(2002-07-01) Boppana, Dinesh; Antonio A. Rene; Sally Blakley; Doug A. MainsDinesh Boppana, The Association Between Medical Insurance Coverage, In-hospital Case Fatality Rate and Length of Hospital Stay Following Admission for Acute Myocardial Infarction in Texas Hospitals. Master of Public Health, July 2002, 53pp., 22 tables, bibliography, 63 titles. This study reports the possible association between type of medical insurance coverage, in-hospital case fatality rates and length of hospital stay following admission for acute myocardial infarction (AMI) in Texas hospitals for the year of 1999. Methods. The data sources was the Texas Health Care Information Council public use data file. Crude and multivariable-adjusted analyses were used to examine the relation between type of medical insurance coverage, length of hospital stay and in-hospital case-fatality rates following AMI. Results. Relative to the referent group of private or commercial insurance patients (odds ratio, 1.0) the multi-variable adjusted odds for dying during acute hospitalization were 1.98 (95% CI, 1.53-2.52) for Medicaid, 1.45 (95% CI, 1.27-1.64) for Medicare. The mean length of hospital stay in days after excluding patients with a prolonged hospitalization was 8.53 (95% CI, 7.93-9.14) for Medicaid, 6.75 (95% CI, 6.52-6.95) for Medicare, and 5.58 (95% CI, 5.37-5.79) for commercial insurance. Conclusions. The findings suggest that patient enrolled in Medicaid and Medicare insurance program had increased in-hospital mortality, and higher length of hospital stay following admission with AMI when compared to the patients enrolled in commercial insurance.Item The Effects of Verbal, General, and Tailored Messages on Participation in a Psychiatric Chemical Dependency Aftercare Program(2002-05-01) Biggs, Quinn M.; Claudia Coggin; Antonio A. ReneBiggs, Quinn M., B.A., The Effects of Verbal, General, and Tailored Messages on Participation in a Psychiatric Chemical Dependency Aftercare Program. Masters of Public Health (Health Behavior), May 2002, 51 pp., 1 table, references, 25 titles. Chemical dependency is a major problem in the United States. Treatment programs are often short-term, relapse rates are high, and continued support is vital for sobriety. Aftercare programs provide continued support, but information encouraging attendance must be effective. Tailored vs. non-tailored health information has been found influential for behavioral change. This study determined the effectiveness of verbal, general, and tailored messages on participation in an aftercare program. Adult patients (N=193) of a psychiatric chemical dependency treatment program were recruited at the time of discharge. Follow up included phone survey and aftercare attendance records. Contrary to hypothesis, there were no significant differences in initial aftercare attendance, recall of aftercare information, or usefulness of information. However, tailored message recipients were significantly more likely to find aftercare interesting, and effect sizes indicated that tailored message recipients found aftercare more helpful and participants were more likely to return to aftercare.Item Use of Body Mass Index as a Predictor of Health Status in Firefighters(2002-05-01) Theurer, Wesley M.; Antonio A. Rene; Sharon ClarkTheurer, Wesley M., Use of Body Mass Index as a Predictor of Health Status in Firefighters. Master of Public Health (DO/MPH), May, 2002, 28 pp., 3 tables, 29 References. This study evaluated the usefulness of BMI as a screening tool for health parameters and duty fitness among firefighters. Our cohort consisted of 218 active firefighters between the ages of 18 and 58 (men 33.5 ±8.6). Two major BMI categorization methods were used: standard [low (30)] and obesity [(normal([less than] 25), overweight(≥25 [less than] 30), obese(≥30 [less than] 39), morbidly obese ≥39)] The mean BMI was 28.8 (±4.5). Standard categorization revealed that nearly 60% had medium or high BMI's; obesity categorization showed 80.7% to be overweight, obese, or morbidly obese. Statistically significant, adverse relationships between BMI and each of the following were found: systolic and diastolic blood pressure, VO2max, METS, and total cholesterol. Inconsistent or statistically insignificant relations were found between BMI and HDL, Chol/HDL ratios, Triglycerides, FVC, and FEV1sec. Tobacco use and participation in an exercise program is also reported. BMI continues to prove useful as a screening tool and may be useful in identifying individual firefighters for health and fitness intervention measures.