School of Public Health
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Browsing School of Public Health by Author "Antonio Rene"
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Item A Descriptive Analysis of Adolescent Pregnancy and Birth Outcomes in Tarrant County, Texas(1999-08-01) Omoloh, Wilfred J.; Gilbert Ramirez; Antonio ReneOmoloh, Wilfred, J., A Descriptive Analysis of Adolescent Pregnancy and Birth Outcomes in Tarrant County, Texas. Master of Public Health, August 14, 1999, 110 pp, 19 tables, reference list, 68 titles. A descriptive study of adolescent pregnancy and birth outcomes in Tarrant county, Texas between 1991 and 1995 was conducted to evaluate the effect of maternal age on infant birthweight and mortality among White, African American, and Hispanic adolescent mothers nineteen years and older. The age of the mother was not a significant predictor of infant birthweight and mortality, but mother’s ethnicity, weight gain, and gestational age were found to be strong predictors of infant birthweight and mortality. The Hispanic ethnic group came out much better than White and Black mothers but no difference between White and Black mothers regarding birthweight was found. The results from the data analysis demonstrated that teenage pregnancy may not be a serious problem in Tarrant County, Texas as was previously though.Item A Study of Hepatitis A Seropositivity in Dallas County, 1998-1999(2001-05-01) Fulda, Kimberly G.; Antonio Rene; John Licciardone; Sally BlakelyFulda, Kimberly G., A Study of Hepatitis A Seropositivity in Dallas County, 1998 – 1999. Master of Public Health (Epidemiology), May 2001, 39 pp., 4 tables, 9 figures, references, 28 titles. The purpose of this study was to determine incidence rates per 100,000 population of hepatits A (HAV) in Dallas County for 1998 and 1999. Individuals who tested seropositive for hepatitis A between January 1, 1998 and December 31, 1999 were included. The variables of interest were sex, race, age, Zone Improvement Plan (ZIP code), and date of occurrence. Rates for 1998 were 1.9 times higher in Dallas County than the United States. In 1999, the Dallas County rate increased over 1.6 times. Rates were significantly higher in males for both years, and rates were highest among Hispanics and lowest among Blacks. Differences in age distribution varied between years by increasing in ages 50 and older in 1999. Several ZIP codes exceeded rates of 20 per 100,000 for both 1998 and 1999. Dallas County met the Advisory Committee on Immunization Practices guidelines for routine vaccination of all children in 1999.Item An Analysis of Patient Health Outcomes in a Cardiac Rehabilitation Program(2000-12-01) Hall, Cortni K.; Antonio Rene; Raghbir Sandhu; Manuel BayonaHall, Cortni K., An Analysis of Patient Health Outcomes in a Cardiac Rehabilitation Program. Master of Public Health, Epidemiology Track, December 2000, 48 pp., 11 tables, references, 30 titles. This study analyzed the coronary risk factor and quality of life outcome results of 55 patients who participated in a 12 week, phase II cardiac rehabilitation program. Baseline and post cardiac rehabilitation data were analyzed. There was an overall improvement of the coronary risk factor variables with significant improvements in functional capacity (p=0.001), diastolic blood pressure (p=0.01), total cholesterol (p=0.017), and LDL 9p=0.01). Significant improvements in the quality of life variables included physical function (p [less than] 0.01), role-physical (p [less than] 0.01), body pain (p [less than] 0.05), vitality (p [less than] 0.05), and social (p [less than] 0.05). There was also a significant finding of improved knowledge (p [less than] 0.01) after completion of phase II cardiac rehabilitation program.Item Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community - A Six Month Follow-Up(1999-12-01) Coustasse, Alberto; Antonio Rene; Doug A. Mains; Gilbert RamirezCoustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results demonstrated a 46% increase in BMI [Body Mass Index]; 62% remained obese; 62% maintained elevated cholesterol or increased cholesterol values to abnormal values; 61% maintained or increased their BP [blood pressure] to abnormal values. A significant finding was that a change of one unit in the BMI correlated with a change of 19.88 mmHg [millimeter mercury] of SBP [systolic blood pressure] and 18.59 mmHg of DBP [diastolic blood pressure]. The societal economic impact of mortality and morbidity (without the benefit of target interventions) for the initial forty-four seniors was projected at & 74,949. Keywords: Health fairs; obesity; cardiovascular; cost; case management.Item Association Between Air Pollution and Daily Mortality in Two Texas Counties(2005-05-01) Espinosa, Isabel Y.; Terry Gratton; Sejong Bae; Antonio ReneEspinosa, Isabel Y., Association of Air Pollution and Daily Mortality in Two Texas Counties. Master of Public Health (Environmental Health), May 2005, 36 pp., 11 tables, 2 illustrations, references, 36 titles. The purpose of this study was to investigate the association between ozone and specific daily mortality in two United States counties, Bexar and Tarrant County, Texas. Daily specific mortality, one hour ozone levels, average temperatures, and Air Quality Index values were obtained for both counties. The results from this study suggest that no association is present between air pollution and specific daily mortality in Bexar County. Further statistical analysis is needed to determine if an association is present in Tarrant County as factors inherent in the collected data could be affecting the results. Investigating the association between ozone levels and hospitalization rates may provide a better description of the relationship and should be considered as a future study.Item Enhancing the Care of the Elderly; An Educational Intervention to Improve Nutritional Knowledge of Nursing Home Staff(1998-06-01) Cummings, Dana; Gilbert Ramirez; Claudia Coggin; Antonio ReneCummings, Dana M., Enhancing the Care of Elderly; an Educational Intervention to Improve Nutritional Knowledge of Nursing Home Staff. Master of Public Health, June 1998, 81 p.p., 5 tables, bibliography, 15 titles. Gross deficiencies exist in the quality and quantity of health care personnel taking care of the aged (Hersch, 1989). Eighty to ninety percent of nursing home staff are untrained aides paid the minimum wage to care for one of the sickest and frailest populations in the United States (Patenaude, 1997). The purpose of this study was to determine if short term nutrition education, utilizing principles for adult learners, would result in knowledge improvement in nursing home staff. An interactive, participatory instructional model was implemented into an existing structure of regular staff inservices to answer this question. To test the effectiveness of the intervention a questionnaire was developed using items from previously validated instruments. Using three nursing homes in the Dallas-Fort Worth metroplex, a total of 157 pre-test and 132 post-test questionnaires were completed. A significant increase in overall knowledge from 80.6% at baseline to 96.1% at post-test was found (p [less than] .001). Participants also showed a significant (p [less than] 0.001) overall increase in knowledge for each of the three learning domains; patient care related to nutrition, food and fluid intake of residents, and eating. These findings suggest that employing short-term education to nursing home staff, using principles for adult learners, can improve nutritional knowledge significantly.Item Epidemiological Modeling of a Bioterrorism Event in a Noncombat Environment(1999-07-01) Perkins, Christopher J.; Antonio Rene; Mains; Gilbert RamirezPerkins, Christopher J., Epidemiological Modeling of a Bioterrorism Event in a Noncombat Environment. Master of Public Health (Biomedical Sciences), July, 1999, 60 pp., 8 tables, 4 illustrations, references, 31 titles. The challenge to government, medical and public health officials is to advocate for American citizens the safest environment possible to live and work. A threat to the safety of all Americans has initiated preparations from national, state, and local jurisdictions in an attempt to counter the probability of biological terrorism. Bioterrorism is not only a threat to humans but also a threat to the nation’s water and food supplies. Epidemiological Modeling of a Bioterrorism Event demonstrates the importance in preparations to reduce the number of casualties and fatalities. Using Epidemiological Modeling of bioterrorism events will aid public health and medical personnel in the planning and initiation of appropriate public health actions and medical therapies should such events occur.Item Epidemiology of Cholera in Malawi, 2002-2003(2004-08-01) Nkhoma, Ella; Sejong Bae; Antonio Rene; Raghbir SandhuNkhoma, Ella, Epidemiology of Cholera in Malawi, 2002-2003. Master of Public Health (Epidemiology), August 2004, 33pp., 4 tables, 3 figures, bibliography, 24 titles. The objective of the present study was to characterize epidemic cholera in Malawi from 2002-2003. National and district-level surveillance records were used for the analyses in this study. The study employed Poisson regression, log-linear analysis, epidemic curve analysis, curve-fitting procedures and epidemic model simulations. District-level determinants of cholera mortality included various sociodemographic indicators. Significant two-way interactions were observed for age and district, with the oldest age group (65+) experiencing the highest risk of symptomatic cholera and residents of Nkhatabay districts also experiencing the most increased risk. Temporal analysis revealed the existence of secondary outbreaks and demonstrated the contribution of preexisting immunity to epidemic dynamics.Item Factors Associated with Multi-Drug Resistance among Patients with Streptoccus pneumoniae Ear Infections(2004-05-01) Mendoza, Belinda A.; Francisco Soto Mas; Chiehwen Ed Hsu; Antonio ReneMendoza, Belinda A., Factors Associated with Multi-Drug Resistance among Patients with Streptoccus pneumoniae Ear Infections. Master of Public Health (Social and Behavioral Sciences), May 2004, 27 pp., 6 tables, 1 figure, references, 9 titles. Clinical trials play an important role in the development of new medical treatments. The purpose of this study is to describe patients participating in a clinical trial and at analyze the socio-demographic characteristics of patients with susceptible and multi-drug resistant Streptococcus pneumoniae ear infections. At the conclusion of this study, a socio-demographic description of clinical trial participants was obtained and the results were slightly younger than patients with susceptible S. pneumoniae ear infections and were more likely to attend day care.Item Line-of-Duty Injury or Illness Incidence in an Air National Guard Unit(2001-05-01) Lorich, Michael F.; Muriel Marshall; Sharon Clark; Antonio ReneLorich, Michael F., Line-of-Duty Injury or Illness Incidence in an Air National Guard Unit. Master of Public Health, DO/MPH track, May 2001, 31 p.p., 3 tables, 4 illustrations, reference list, addendum. Line-of-duty injuries or illnesses (LODs) suffered by members of Air National Guard units may demonstrate the status of unit safety, unit readiness and deployability, a potentially significant area of unit expenditures, and areas of needed health promotion. This descriptive pilot study was conducted at the unit commander’s request to determine an apparent doubling of the prevailing incidence of LODs over a recent quarterly period. Tracking of injuries and injured individuals was problematic. The vast majority of LODs were musculoskeletal in nature. Decreased fitness level (Identified as elevated body mass index (BMI)) among males and increased age were related to increased LODs. Recommendations were given to improve tracking, identify individuals at increased risk, provide pre-training assessment, and institute health promotion focused on musculoskeletal injuries.Item Obesity and Risk of Stroke in NHANES I Follow Up Study(2002-12-01) Soman, Ashwini; Umed Ajani; Antonio Rene; Karan SinghSoman, Ashwini, Obesity and risk of stroke in NHANES-I follow-up study, Masters of Public Health (Epidemiology), December 2002. 79pp., 20 tables, 3 illustrations, bibliography, 46 titles. Stroke is the third leading cause of death in the US. Role of obesity as an independent risk factor has been relatively well established for coronary heart diseases but not for stroke. Purpose of this study was to assess long-term risk of stroke due to obesity measured at baseline. The research was conducted using First National Nutritional Health and Examination Survey and its follow ups. Overall, increased risk of stroke was observed in obese individuals (BMI [greater than] 30 kg/m2). Similar association was observed in different subgroups of race, gender, those with or without diabetes and cardiovascular disease.Item Patterns of Primary Surgical Procedures Among Men Admitted to Texas Hospitals with a Diagnosis of Prostate Cancer(2001-12-01) Galdiano, Rosemary; Antonio Rene; Doug A. Mains; Sue LurieGaldiano, Rosemary, Patterns of primary surgical procedures among men admitted to Texas hospitals with a diagnosis of prostate cancer. Master of Public Health (Epidemiology), December 2001, 28 pp., 3 tables, 4 illustrations, references, 21 titles. Data for the Texas Health Care Information Council was analyzed to identify the patterns of surgical procedures among men admitted to 114 Texas hospitals with a diagnosis of prostate cancer in 1999; and to determine whether these patterns varied by race and age. In all, 4,608 cases were compared for differences between age, race and type of surgical procedure using Pearson’s chi-square test. Frequencies were tabulated for age, race, length of stay, type of surgery, and type of insurance. Radical prostatectomy and transurethral resection of the prostate are the most common procedures performed. Black and Hispanic men less than 45 years old were more likely to receive radical prostatectomy than whites. Transurethral resection of the prostate (TURP) is most commonly performed in men 75 years and older with higher proportions among black and Hispanic men. Younger men (ageyears) who received TURP were more likely to be white. White men between the ages of 45 and 84 were more likely to receive perineal prostatectomy. These findings identified patterns of treatment with defined differences between age and race.Item Predictors of In-Hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System(2001-07-01) Zhang, Huiling; Karan Singh; Antonio Rene; Sally BlakleyZhang, Huiling. Predictors of In-hospital Mortality Among Acute Myocardial Infarction Patients in a Large Health Care System. Master of Public Health, July 2000, 29 pp., 4 tables, 29 references. Background---There is increasing interest in the identification of risk predictors for in-hospital mortality due to acute myocardial infarction (AMI). To date, there has been no AMI in-hospital mortality prediction models developed using clinical database. Methods and Results---The study population consists of 4,167 AMI cases admitted to 36 hospitals in 3 states. Thirty variables were selected as candidate predictors, and 19 showed significant bivariate association with AMI in-hospital mortality. By applying multiple logistic regression and stepwise selection, 10 variables were selected for inclusion in the final prediction model: age, arrive from cardiac rehabilitation center, CPR on arrival, Killip class, AMI with comorbidities, AMI with complications, PCTA performed, beta-blockers given, ACE inhibitors given, Plavix given. Conclusion---A ten-variable in-hospital mortality prediction model for AMI patients, which includes both risk factors and beneficial treatment procedures, was developed. Chi-square goodness of fit test suggested a very good fit for the model.Item Prevalence of Hand, Finger, and Wrist Musculoskeletal Problems in Keyboard Instrumentalists: The University of North Text Musician Health Survey(2000-05-01) Pak, Chong H.; Sally Blakley; Antonio Rene; John LicciardonePak, Chong H., Prevalence of Hand, Finger, and Wrist Musculoskeletal Problems in Keyboard Instrumentalists: the University of North Texas Musician Health Survey. Master of Public Health, May, 2000, 52 pp., 7 tables, references, 69 titles. Data were derived from the University of North Texas Musician Health Survey, involving keyboard instrumentalists. 455 keyboard instrumentalists were selected and musician type, daily playing time, gender, and age were examined as possible risk factors for musculoskeletal problems of the hand, finger, and wrist. Age was found to be a significant risk factor when all levels of pain were considered. Gender was found to be a significant risk factor for all levels of pain as well as severe pain. Musician type and daily playing time did not show statistical differences.Item Risk Factors Associated with Low Bone Mineral Density and Hip Fracture Among United States 20-90 Years of Age (NHANES III Study)(1999-06-01) Nandi, Shubhra; Antonio Rene; John Licciardone; Nelson C. FongNandi, Shubhra. Risk Factors Associated with Low Bone Mineral Diversity and Hip Fracture Among United States Females 20-29 Years of Age. (NHANES III Study). Master of Public Health, June 1999, 45p.p. Osteoporosis has become a great public health problem because of the growing segment of the elderly population. The manifestation of osteoporosis results in morbidity with disability and a diminished quality of life due to hip fracture and spine fracture. This is also the major cause of hospital expenditure. Thus, understanding the development of low bone mineral density at various skeletal sites and the prevention of the causes related to the diminished bone mineral density is of great importance. This is a descriptive study of risk factors associated with low bone mineral density and hip fracture among United States females 20-90 years of age. Data was collected by the National Center for Health Statistics from 1988-1994 in two phases. Several risk factors have been associated with low bone mineral density. They are age, race, body mass index, fat-free mass, smoking, alcohol intake, caffeine intake, calcium supplement intake, dairy intake, and the level of physical activity. The primary objective of this study was to elucidate the relationship of low bone mineral density in a specific race-ethnic population with the perceived risk factors. This cross-sectional study provides information to confirm that Non-Hispanic Whites have low bone mineral density at the end of their decade of life compared to Non-Hispanic Blacks and Hispanic Americans. A significant association between low bone mineral density and age, race ethnicity, body mass index, and milk intake was detected (P [less than] 0.05). Other factors did not display any statistically significant correlation.Item Risk Factors for Childhood Asthma in the United States: A Cross-Sectional Study Based on NHANES 1999-2000 Data(2005-05-01) Alvarez-Garriga, Carolina; Raghbir Sandhu; Daisha Cipher; Antonio ReneAlvarez-Garriga, Carolina, Risk Factors for Childhood Asthma in the United States: A Cross-Sectional Study Based on NHANES 1999-2000 Data. Doctor of Public Health (Epidemiology), May 2005, 114 pp., 18 tables, 4 figures, bibliography, 93 titles. The purpose of this study was to identify and assess risk factors for childhood asthma. A total of 158 asthmatics were compared to 1,104 non-asthmatics regarding selected factors by using the multiple logistic regression adjusted odds ratio as a measure of association. A 2.3 times higher prevalence (13.8 per 100) was found for the U.S. than that reported in the previous national surveys (NHANES III) during 1994 (5.9 per 100). Males and all race/ethnic minorities showed higher probability to have asthma. Income was inversely related to having asthma, and, among other results, renting a house, low birthweight, hay fever, chickenpox, learning disabilities, ear infections, trouble seeing even with glasses, and not covered by private insurance had higher chance of having asthma. Childhood asthma is still alarmingly increasing, and results from this study about high-risk groups and modifiable factors can be used for public health interventions.Item Risk for Stroke Among Migraine Sufferers(2001-05-01) Hall, Rebecca G.; Antonio Rene; Manuel BayonaHall, Rebecca G., Risk for Stroke Among Migraine Sufferers. Master of Public Health (Epidemiology), May, 2000, 27 pp., 9 tables, references, 33 titles. The objective of this study was to investigate, using the National Health Interview Survey (NHIS), whether those who suffer from migraine or severe headache do. Odds ratios were calculated for stroke among migraine sufferers compared to those who do not suffer from migraine. Results were adjusted for age, gender, and race. Risk factors for stroke were also analyzed. The crude odds ratio for stroke among migraine sufferers compared to non-migraine sufferers is 2.17, increasing 3.77 with age-adjustment. These results suggest that vascular events that are associated with migraine may also be associated with an increased risk for stroke. Discovering the mechanism that generates this relationship has widespread implication to the population and may save taxpayers billions of dollars annually be leading to better treatments for and possible prevention of migraine.Item Stress and Social Support as Risk Factors for the Occurrence of Neural Tube Defect-Affected Pregnancies in Women Living Along the Texas-Mexico Border(1999-06-01) Herron, Kathryn M.; Antonio Rene; John Licciardone; Gilbert RamirezHerron, Kathryn M., Stress and Social Support as Risk Factors for the Occurrence of Neural Tube Defect-Affected Pregnancies in Women Living Along the Texas-Mexico Border. Master of Public Health, June, 1999, 59 pp., 8 tables, 1 figure, references, 78 titles. Data were derived from the case-control study of the Texas Department of Health’s Neural Tube Defect Project, involving women living along the Texas-Mexico border, June 1995 to October 1998. Social support and stress information was obtained from a questionnaire, and a residual stress scale was created to determine an aggregate measure for each subject. Interviews were conducted with 261 women, with 1.2 controls to each case. Having high residual stress was found to be a significant risk factor for NTDs. Other significant risk factors included periconceptional injury, residential mobility, having no relatives to talk about private matters, and discontent with relationships.Item The Effects of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women(2001-05-01) Hathwar, Supriya; Sally Blakley; Steven Blair; Antonio ReneHathwar, Supriya, The Effect of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women, (ACLS 1970-1999). Master of Public Health (Epidemiology), May, 35 pp., 6 tables, references, 48 titles. Osteoarthritis (OA) of the hip and knee is one of the most important causes of pain and disability affecting nearly 21 million people in the United States. Obesity is one of the primary causes of secondary osteoarthritis especially of the hip and knee. (Felson, 1992). The aim of this prospective cohort study is to determine whether higher levels of CRF reduce the risk of development of OA in women across different body mass index (BMI) levels. The study population consisted of 3847 women, ages 20-87, examined at the Cooper Clinic, Dallas, Texas between 1970 and 1999. There were 379 cases of physician-diagnosed OA during 31,657 woman-years of follow-up. After adjustment for age, exam year and health status, obesity and overweight were found to be significant predictors of OA in women. At all levels of CRF, the odds of developing OA increase as weight increases. In the overweight category, the odds of developing OA are 80% higher among the low-fit women [OR=1.8,95% CI (1.1-3.1)], and 60% higher among the moderately fit women [OR=1.6,95%CI (1.0-2.3)] compared to high fit, normal weight women. In the obese category, the low-fit and the high fit women had the same odds of developing OA (OR=2.6), while moderately fit women had lower odds of developing OA (OR=1.7). These data suggest that CRF is not a consistent predictor for development of OA in women.Item Utilization of Ambulatory Care for Osteoarthritis Treatment, 1998(2001-05-01) Davidson, Latunya N.; Antonio Rene; Karen Godwin; Umed AjaniDavidson, Latunya N., Utilization of Ambulatory Care for Osteoarthritis Treatment, 1998. Master of Public Health (Epidemiology), May 2001, 26 pp., 4 tables, bibliography, 21 titles. Osteoarthritis (OA) is one of the most frequent causes of physical disability among the adult population. It is estimated that more than 20 million people in the United States have osteoarthritis and more than 50% of those 65 and older have evidence of the disease. The debilitating effects of the disease are responsible for more than 7 million physician visits annually. In fact osteoarthritis account for more hospitalizations than rheumatoid arthritis each year. Treatment costs to the patients, healthcare expenditures, increasing prevalence of the diseases, and its effect on disability are all major public health issues. The purpose of this research is to identify characteristics as they relate to the type of ambulatory visits and the therapeutics services provided. Factors to be considered include: age, gender, race, ethnicity and source of payment for services. Data will be obtained from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) of 1998. Information obtained from this research may influence future public health decisions regarding education, treatment and management of chronic conditions such as osteoarthritis.