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Item A Clinical Research Study Involving the Use of Erythropoietin in Perioperative Patients Undergoing Surgery for Gynecologic Cancer(2002-07-01) Larson, Sharon Beth; Richardson, Barbara; Martin, MichaelThe purpose of this internship practicum report is to analyze the pathophysiology and impact of anemia in low-income gynecologic cancer patients. The report also assesses the impact of erythropoietin on hemoglobin levels prior to gynecologic cancer surgery. This report is based on a clinical research study to determine whether or not erythropoietin will mitigate the suppression of bone marrow inherent to the gynecologic cancer population and alleviate some of the symptoms and side effects of the anemia.Item A Cost Analysis of Tuberculosis and its Prevention in Tarrant County, Texas(2007-05-01) Miller, Thaddeus L.; Scott McNabb; Peter Hilsenrath; Jotam PasipanodyaMiller, Thaddeus L. A Cost Analysis of Tuberculosis and its Prevention in Tarrant County, Texas. Doctor of Public Health (Health Management and Policy), May 2007, 232 pp., 29 tables, 2 illustrations, bibliography, 274 titles. Tuberculosis cost has been incompletely described as the cost arising from acute illness and treatment. The societal cost of tuberculosis arises from infection, suspicion of infection, acute and preventive responses, the sequalae of illness (including acute morbidity, drug induced hepatitis, mortality, and disability), and the compounding effects of transmission. This societal cost in unknown however the variable portion of this cost is equivalent to the savings made possible by averting tuberculosis, This study measured the societal cost of tuberculosis in Tarrant County, Texas, for the year 2002. Societal costs were estimated as the sum of known or estimated expenditures and health losses related to tuberculosis and discounted at 3%. Current and future costs will accrue to an estimated net $33.9 2002 USD million for the year 2002 in Tarrant County, Texas. An average of 1.4 QALYs net of 3% social discount were lost per incident case. The greatest burdens of tuberculosis, when analyzed by either cost or health quality, can be averted only by case prevention. Forty-three and 44% of societal cost was generate by secondary transmission and chronic impairment associated with pulmonary tuberculosis. Neither factor is routinely considered in discussions of tuberculosis cost. Acute treatment, hospitalization and direct medical care account for only 2.4% of societal cost. Any intervention that prevents one tuberculosis case will prevent at least a net $295,182 (2002 USD) and individual health quality losses averaging 1.4 net QALYs.Item A Look at Diabetes Mellitus and the Effects of a Study Drug on Diabetic Nephropathy(2002-08-01) Schlueter, Cynthia K.; Debbie Lewis; Clifton Cage; Rustin ReevesDuring my internship, I assisted with a twenty-four week, phase 2, double blinded, placebo controlled trial for a drug being developed to slow, if not prevent, the development of ESRD from overt neuropathy in patients with both type 1 and type 2 diabetes. This drug is a naturally occurring component of vitamin B6 and is an AGE-inhibitor. The AGE-inhibitory effect of the study drug was discovered by isolating Amadori products in the pathway to AGE formation. Once the intermediates were isolated, the sponsor’s scientists searched for compounds that could specifically block the conversion of these Amadori products into AGEs. The study drug was found to be a strong inhibitor of this pathway. In comparison, the common AGE inhibitor, aminoguanidine was found to be ineffective in blocking the post-Amadori foundation AGEs. Therefore, it must block AGE formation at one of the less clinically relevant pathways, and should be less effective in treating nephropathy according to the sponsor’s scientists. This study included type 1 and type 2 patients with clinically diagnosed diabetic retinopathy and a urinary albumin excretion rate (UAE) of greater than 300 mg/24h. Other inclusion and exclusion criteria were applied for the safety of the subjects and greater viability of the data.Item A Novel sRNA Member of the Carbon Storage Regulatory System of Escherichia Coli(2002-12-01) Weilbacher, Thomas; Jerry SimeckaWeilbacher, Thomas S., A Novel sRNA Member of the Carbon Storage Regulatory System of Escherichi coli. Master of Science (Microbiology & Immunology), December, 2002, 57 pp., 2 tables, 12 illustrations, bibliography, 44 titles. Small untranslated RNAs (sRNAs) perform a variety of important functions in bacterial systems. The 245 nt sRNA of Escherichia coli K-12, CsrC, was uncovered using a genetic screen for genes that regulate glycogen biosynthesis. CsrC RNA binds multiple copies of CsrA, a protein that post-transcriptionally regulates central carbon flux, biofilm formation, and motility in E. coli. CsrC antagonizes the regulatory effects of CsrA, presumably by sequestering this protein. The discovery of CsrC is intriguing, in that a similar sRNA, CsrB, performs essentially the same function. Both of these sRNAs possess similar imperfect repeat sequences (18 in CsrB, 9 in CsrC), primarily localized in the loops of predicted hairpins, which may serve as CsrA binding elements. Transcription of csrC increases as the culture approaches the stationary phase of growth and is activated by CsrA and the response regulator UvrY. Complementation and in vitro transcription-translation experiments reveal that CsrA effects on csrC are mediated indirectly, through UvrY. Because CsrB and CsrC antagonize the activity of CsrA and are dependent on CsrA for their synthesis, a csrB null mutation causes a modest compensatory increase in CsrC levels and vice versa. An updated model for the signaling circuitry of the Csr system is discussed.Item A Review of the Literature on Faith-Based Organization's HIV/AIDs Care and Prevention Efforts in Sub-Saharan Africa(2005-05-01) Rojas, Zeida G.; Lurie, Sue; Urrutia-Rojas, XimenaRojas, Zeida G., A Review of the Literature on Faith-Based Organization’s HIV/AIDS Care and Prevention in Sub-Saharan Africa. Master of Public Health (Community Health), May 2005, 83 pp., 20 diagrams, bibliography, 10 titles. The thesis assesses the role of faith-based organizations (FBOs) involved in HIV/AIDS related care and prevention activities in Sub-Saharan Africa. Do FBOs have the ability to address the multi-faceted syndrome that HIV/AIDS brings to an individual, their family and community? Can FBOs be effective partners to carry out prevention and care initiatives? Faith-based organizations are generally overlooked as potential partners and leaders in the fight against HIV/AIDS. FBOs are often the only genuine nongovernmental organizations in many rural parts of poor countries, or at a minimum, they are the strongest and most influential. Due to their organizational networks, FBOs are able to mobilize people and resources, and to reach rural or isolated areas. Evidence of current FBO efforts demonstrates that FBOs have the ability to address the multifaceted effects of HIV/AIDS and can become indispensable partners for government health agencies and NGOs.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 A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage Among a Sample of HIV-Positive Adults(2006-12-01) Wittenmyer, Brian F.; Kristine Lykens; Jeffrey Talbert; Tim StrawdermanWittenmyer, Brian F., A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage among a Sample of HIV-Positive Adults. Master of Public Health (Health Management and Policy), December 2006, 88 pp., 8 tables, references, 32 titles. Anti-retroviral medications (ARV) are effective at treating HIV/AIDS. Medicare, Medicaid, and ADAP are public programs that supply ARVs to needy patients in the U.S. Studies have documented dispartities in AIDS incidence/prevalence, insurance, and ARV-use. The study described demographic, clinical, and insurance characteristics of a sample of HIV+ persons. The study explored relationships between AIDS diagnosis, health status, and ARV-receipt and demographic, insurance, and clinical variables. Disparities in ARV-receipt, AIDS diagnosis, and health-status were found for gender, age, race, geographic region, and SES. Policy recommendations included: shortening the disability waiting-period for Medicare-eligibility, and relaxing Medicaid’s income-eligibility requirements.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 A Study of the Effectiveness and Tolerability of Weekly Rifapentine/Isoniazid for Three Months Versus Daily Isoniazid for Nine Months for the Treatment of Latent Tuberculosis Infection(2004-11-01) Lemp, Jessie; Patricia Gwirtz; Walter McConathy; Richard EasomLemp, Jessie M. A Study of the Effectiveness and Tolerability of Weekly Rifapentine/Isoniazid for Three Months Versus Daily Isoniazid for Nine Months for the Treatment of Latent Tuberculosis Infection. Master of Science, November, 2004, 107 pp., 4 tables, 4 figures, references, 29 titles. The standard treatment for latent tuberculosis infection, nine months of daily isoniazid, is effective at preventing active tuberculosis; however, its full benefits are limited by non-adherence. A shorter intermittent regimen of rifapentine plus isoniazid once weekly for three months is equally effective as the standard regimen in animal models. This regimen facilitates the use of directly observed therapy, a method that significantly improves adherence. The Center for Disease Control is sponsoring Study 26 to test the effectiveness and tolerability the three-month rifapentine based regimen in latently infected persons with risk factors for progression to active tuberculosis. This thesis will describe the background rationale and methods for the clinical trial, and the internship experience.Item A Study to Determine Improved Compliance of Biophosphonate Treatment in Subjects with Osteoporosis(2005-02-01) Enard, April T.; Gwirtz, Patricia A.; Jimenez-Williams, Cynthia; Rubin, BernardEnard, April T. A Study to Determine Improved Compliance of Bisphosphonate Treatment in Subjects with Osteoporosis. Master of Science, February 11, 2005. The ability of patients to adhere to treatment regimens is very poor and continues to impede optimal therapy of osteoporosis. The shortcomings in treating osteoporosis are: a) noncompliance and/or lack of continued persistence of therapy, b) efficacy of therapy on bone turnover marker levels and fracture prevalence, and c) tolerability of therapy to patients. Studies have shown that interventions such as education and awareness of bone mineral density promote patient usage compliance. The slightest improvement in compliance allows further understanding of accurate efficacy of medication therapy to fractures, bone marker levels, and overall improvement of bone mass. Increased compliance/persistence allows accurate comparison of bisphosphonates to one another for effectiveness on osteoporosis patients and allows improvement opportunity in treatment modalities that can positively influence the course of osteoporosis. This phase IV study targets compliancy/persistence in bisphosphonate therapy in treatment of osteoporosis.Item A Sun Awareness Pilot Project(2002-05-01) Franklin, Gillian A.; Claudia Coggin; Kristine A. Lykens; Doug A. MainsFranklin, Gillian A., A Sun Awareness Pilot Project. Masters of Public Health (Health Management and Policy), May 2002, 53 pp., 7 tables, bibliography, 48 titles. The most common cancer in the United States today is skin cancer; it is also the most preventable. At least 90% of all skin cancers is caused by sun exposure. Americans have a one in six lifetime risk of developing skin cancer and in Texas the rate is one in three. The purpose of this pilot project was to increase the level of sun protection knowledge and awareness in parents who brought their children in for a six-month immunization visit. The project was modeled after the Australian Cancer Council’s “Slip! Slop! Slap!” campaign. Data was collected from five pediatric clinics in this pretest/posttest design study. Multiple variables regarding demographics, skin type, knowledge, beliefs, sun-protective practices, and attitudes were included. Overall, parental sun protective knowledge and awareness increased. The information obtained from this pilot project may influence future public health decisions regarding education and prevention of skin cancers.Item Access to Health and Social Services for Poverty Level Adults with Chronic Disease or Disability(2006-12-01) Reese, Sharon E.; Kristine Lykens; Sue Lurie; Richard ScotchReese, Sharon E., Access to Health and Social Services for Poverty Level Adults with Chronic Disease or Disability. Doctor of Public Health (Health Management and Policy), December, 2006, 79 pp., 7 tables, 51 references. This dissertation reports the results of research into the difficulties poverty level adults with disabilities have in accessing vital health and social services. Chapter one gives a background of the problem, a purpose of the research, the research question, limitations and constraints, and the importance of the study. Chapter two is a review of the literature concerning this population and access. Chapter three reviews the methodology used in the study, with chapters four and five presenting results, conclusions and recommendations. Qualitative methods using a focus group and individual interviews five major themes emerged: health issues, access or obtaining care, interactions with providers, obtaining medication, and transportation (table 6). A review of these themes and the particular responses of participants in these areas highlighted the need for policy change in the area of access to services for this special group. This dissertation also makes recommendations for policy changes and potential barriers to those changes.Item Activities of Daily Living and Cardiovascular Risk Factors' Impact on Cardiovascular Disease (CVD) and Cognitive Functioning: A Three Stage Longitudinal Model(2005-05-01) Bozo, Ozlem; Guarnaccia, Charles A.; Hall, James; Kelly, KimberlyBozo, Ozlem, Activities of Daily Living and Cardiovascular Risk Factors’ Impact on Cardiovascular Disease (CVD) and Cognitive Functioning: A Three Stage Longitudinal Model. Doctor of Philosophy (Health Psychology), May, 2005, 122 pp., 23 tables, 4 figures, references, 50 titles. The purpose of this study was to examine the longitudinal relationship of daily living (ADL), cardiovascular risk factors, and cardiovascular diseases to predict the future cognitive functioning of older Americans who are between the ages of 51 and 61 at the time of initial assessment. Three waves of the Health and Retirement Study (HRS) database between the years of 1992 and 2002 were examined with path analysis. The longitudinal hypotheses of the study were that (1) ADLs would positively predict future cognitive functioning, (2) ADLs would negatively predict future cardiovascular risk factors, (3) ADLS would negatively predict future cardiovascular diseases, (5) cardiovascular risk factors would negatively predict future cognitive functioning, (6) cardiovascular disease would negatively predict future cognitive functioning, (7) cardiovascular risk factors would mediate the relationship between ADLS and cardiovascular disease, and (8) cardiovascular disease would mediate the relationship between cardiovascular risk factors and cognitive functioning. The results of the analyses indicate that there was no effect of cardiovascular disease on cognitive functioning; however, there were significant effects of cardiovascular risk factors on cognitive functioning that ranged between B=-/021 and B=-/145. Moreover, it was found that cardiovascular risk factors mediate the relationship between ADLs and cognitive functioning, while cardiovascular disease does not. These results suggest that addressing cardiovascular risk factors may be more important than addressing existing cardiovascular disease to protect future cognitive functioning. This shows the importance of primary/secondary prevention versus tertiary interventions.Item Alterations in mRNA Levels of Selected Gene Products During Hypoglycemia, Hypoxia, and Ischemia Induced Apoptosis of Cultured Rat Retinal Ganglion Cells(2001-08-01) Vopat, Kelly S.; Agarwal, Neeraj; Wordinger, Robert J.; Pang, Iok-HouVopat, K., Alterations in mRNA Levels of Selected Gene Products during Hypoglycemia, Hypoxia, and Ischemia Induced Apoptosis of Cultured Rat Retinal Ganglion Cells. Master of Science (Biomedical Science), August 2001. 54 pp., 2 tables, 10 illustrations, bibliography, 105 titles. In order to explore the mechanisms involved in the signal transduction pathways of ischemia-induced apoptosis of RGCs in glaucoma, an in vitro ischmia model of transformed rat retinal ganglion cells (RGC-5) was utilized. RGC-5 cells were exposed to hypoglycemia, hypoxia, and ischemia for six hours. Hypoxia and ischemia resulted in apoptosis of RGC-5 cells as determined by TUNEL assay. The bax mRNA levels increased significantly in cells exposed to hypoxia. The mRNA levels of hemoxygenase, c-fos HSP 70, and BDNF showed a trend of increase in both the hypoxic and ischemic conditions. These results demonstrate that retinal ganglion cells undergo apoptosis in hypoxic conditions likely via an increase in bax/bcl-2. The up-regulation of BDNF and some stress proteins may be part of a cellular rescue effort trying to overcome the damage created by hypoxic and ischemic stresses.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 An Analytical Study of the Perceptions, Prevention Strategies, Treatment and Economic Impact of Equine West Nile Virus(2004-06-01) Galvan, Robert; Lurie, Sue; Singh, Karan; Gonzalez, AdelaGalvan, Robert, M.P.H., M.S. An Analytical Study of the Perceptions, Prevention Strategies, Treatment and Economic Impact of Equine West Nile Virus. Doctor of Public Health, Social and Behavioral Sciences, June 2004, 109 pp., 16 Tables, 15 Figures, 47 Titles. Since the introduction of the West Nile Virus (WNV) in the United State in 1999, WNV has been the cause of disease and deaths in humans, wild birds, zoo birds, and horses. In 2002, more than 15,000 equines in 40 states were diagnosed with illness associated with WNV. Approximately one third of those horses died or were euthanized (Campbell et al, 2002). Horses are infected with the WNV more often than humans or any other mammal. It is becoming on e of the fastest growing health threats to horses nationwide. Texas responded to the discovery of WNV by expanding their surveillance systems in the eastern counties of the state (Texas Department of Health, 2003). Positive reports for WNV were announced in 2002, which prompted an increase in public education and equine vaccination recommendations. Although much has been reported on the economic impact WNV has on human health and hospital care facilities, documentation is lacking on these issues in the equine population. Understanding the biology, epidemiology, economic impact, and how WNV affects the equine industry are important aspects to public health programs and prevention activities. The objectives of this study are to: (1) examine WNV cases in the equine population in Texas in order to better understand the distribution of clinical disease, signs, treatments and outcomes; (2) to provide information regarding the perceptions, knowledge, concerns, and treatment of the WNV by Texas veterinarians; and (3) to determine the economic impact of the WNV on the equine population in the state. A 14 question survey was mailed to licensed veterinarians in Texas in an effort to gather information about their perceptions and beliefs of the WNV, recommended treatment preferences, and the estimated cost of treatment. Outcomes included case fatality rate, descriptive data, veterinarians’ knowledge of WNV, veterinarians’ beliefs/perceptions of WNV, and the economic impact of WNV. Descriptive analyses were performed by using SPSS version 11. The methods used for analysis of WNV data were primarily simple descriptive statistics including summations and frequencies. A cross-tabulation was performed between the results of Questions 1, 2, and 3 and a variable created to approximate the number of veterinarians that actually treated cases of WNV (treat). A cross-tabulation and Chi-square analysis was performed between the treatment variables (treat) and derived variables of Questions 1, 2, and 3 to examine differing beliefs and knowledge between veterinarians who had treated WNV and those who had not. Seven hundred of 4,177 surveys returned yielded a response rate of 16.8 percent. Among the veterinarians, 73.4% (514/691) believed that they are receiving or received enough training and/or education concerning WNV. The vaccination regimen is believed to be effective and reliable by 56.1% (393/691) of the respondents. There were 1,256 cases of equine WNV reported confirmed via laboratory testing. There were also 766 cases reported that were not confirmed via laboratory testing. Among the 2,022 diagnosed cases, 257 were vaccinated against WNV prior to illness; and, 159 cases were vaccinated after signs of illness. A total of 441 horses died as either a direct cause of the disease or by owner or veterinarian elected euthanasia. The most common criteria used to decide euthanasia in these horses was prolonged recumbency as reported by 44.2% (87/197) or the veterinarians. Fifty-two percent (233/488) of the veterinarians did not recommend prevention strategies to equine owners. The cost of vaccination regimen was reported by 63% (269/434) of the veterinarians to be $25 or less. The results of the survey suggest that there could be a need for WVN education among veterinarians in areas of prevention, control, and treatment. Future studies should be conducted to examine owner perceptions, knowledge and beliefs of WNV vaccinations and prevention strategies. Values for lost horses were not solicited in the survey, thus, a total economic impact could not be completely estimated. However, a formula to approximate the aggregate economic impact of the WNV on the Texas equine industry was employed.Item An Evaluation of Acanthosis Nigricans School Screening Results in Richardson Independent School District to Determine the Association of Acanthosis Nigricans and Other Factors for Type 2 Diabetes Mellitus(2005-05-01) Gardner, Janet E.; Urrutia-Rojas, Ximena; McConathy, Walter J.; Cipher, Daisha J.Gardner, Janet E., An Evaluation of Acanthosis Nigricans School Screening Results in Richardson Independent School District to Determine the Association of Acanthosis Nigricans and Other Risk Factors for Type 2 Diabetes Mellitus. Master of Public Health (Community Health), May 2005, 65 pp., 11 tables, reference list, 47 titles. Cases of Type 2 diabetes mellitus (T2DM) have been increasing at alarming rates in Texas. Identifying underlying factors, such as acanthosis nigricans (AN), elevated body mass index and hypertension, which might contribute to the development for type 2 diabetes, is critical. This study analyzed the relationship of AN with these risk factors of T2DM. Richardson Independent School District screening results for 2003-2004 were analyzed. This study concluded that calculated BMI values yielded the highest association with grades of AN. BMI-for-age percentiles greater than or equal to the 95th percentile and elevated diastolic and/or systolic blood pressures were strongly associated with AN grades.Item Association Between Breastfeeding and Asthma: A Cross-Sectional Study(2003-08-01) Trombley, Ann M.; Manuel Bayona; Raghbir SandhuTrombley, Ann M., Association Between Breastfeeding and Asthma: A Cross-Sectional Study. Master of Public Health (Epidemiology), August 2003, 17 pp., 12 tables, bibliography, 54 titles. Controversy has surrounded the topic of breastfeeding and if it provides a protective effect against childhood asthma. The objective of this study was to assess whether a relationship exists between breastfeeding and childhood asthma. This study also examined several significant predictors of childhood asthma. A cross-sectional study was conducted using NHANES 1999-2000 data to identify and assess the crude and multivariate associations between the above mentioned variables and asthma and the effect that breastfeeding has on these relationships. Prevalence of asthma in this study was 12.5 per 100. Mexican Americans were found to have a protective association with the development of asthma. A strong protective association was found for those who were breastfed and the development of childhood asthma (OR=0.693, p-value=0.014).Item Asthma Mortality and Toxic Release in Texas - An Ecological Study 1980-2001(2004-05-01) Maddipatla, Sreeram; Manuel BayonaMaddipatla, S., Asthma Mortality and Toxic Release in Texas - An Ecological Study 1980-2001. Master of Public Health (Environmental Health) April 2004, 97 pp., 4 tables, bibliography, 94 titles. There is a lack of literature examining how the spatiotemporal trend of asthma may have impacted different ethnic/racial compositions of Texans. The present study sought to evaluate the geographic-temporal variations in asthma mortality in Texans over a 22-year period, retrospectively, and examine whether the trend of environmental Toxic Release Inventory (TRI) concentrations and their spatiotemporal persistence might place an uneven burden on particular racial groups. The study concentrates on the time period between 1980-2001 and first evaluates geographic excess of asthma mortality in different racial groups at the county level and characterizes the excess burden by spatiotemporal variations. After this assessment, the impact of TRI on asthma mortality over this period of time is analyzed. Based on these two analyses, this would identify which racial/ethnic groups in which Texas regions might have been affected the most by regarding mortality over time, and suggested priority geographic areas for policy intervention. At the end of this study, it could be said that there might be an association between the TRI release and increased asthma mortality in the Black male population.Item Characterization of MRSA Infection at Childrens Medical Center, Dallas, January 2005-June 2005(2006-05-01) Okoro, Ngozi M.; Raghbir Sandhu; Claudia S. Coggin; Sejong BaeOkoro, Ngozi M., Characterization of MRSA infection at Childrens Medical Center, Dallas, January 2005-June 2005. Master of Public Health (Epidemiology), May 2006, 33p., 14 tables, 10 illustrations, bibliography, 13 titles. MRSA infection is increasingly emerging in patients without the established risk factors hence the term CAMRSA. This study is a descriptive secondary data analysis from an ongoing study at UTSM/CMCD and describes the CMCD patients with MRSA infection. Data analysis showed a consistent increase in the incidence rate of the infection with slight female preponderance. Race distribution showed that blacks were the majority. Most children were less than 2years, used Medicaid, had superficial infections and community-acquired infections. All (100%) isolates were susceptible to Vancomycin and Linezolid while many (92.2%) were resistant to Erythromycin. The increasing incidence in CAMRSA infection remains a challenge for public health professionals and the resistant pattern a potential problem to the pharmaceuticals.