Browsing by Subject "Pediatrics"
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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 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 Barriers to Medicaid Enrollment: A Study of the Texas Healthy Kids Corporation(2000-12-01) Barlow, Daphne J.; Doug A. Mains; Sally BlakleyBarlow, Daphne J., Barriers to Medicaid Enrollment: A Study of the Texas Healthy Kids Corporation. Masters of Public Health (Health Administration), December, 2000, 38 pp., 18 tables, References, 13 titles. Recently Medicaid eligibility was expanded to include more children than ever before in Texas. However, many Medicaid eligible families have not obtained benefits. This study concerns potentially Medicaid eligible families who applied to the Texas Health Kids Corporation. A random telephone survey of these applicants examined the outcome of Medicaid eligibility notification. Data was analyzed to determine the predictors of attempting or completing an application. No significant sensitivity to profilers such as primary language, race/ethnicity, education level or age was detected. Instead, having prior knowledge of Medicaid eligibility and being female were predictive factors to consider when engineering outreach programs. While these results indicated a statistical significance, further study of repeat notification and gender in order to conclusively recommend policy change. These results have implicated for the Texas CHIP program.Item Blackwell, Deborah, D.O.(1994-03-31) Blackwell, Deborah; Hailey, BlakeDr. Blackwell, a graduate of TCOM, joined as a faculty member for the department of Pediatrics in 1989. She eventually became Assistant Dean for Clinical Affairs and discusses her work with OMCT and the school. Interviewed by Blake Hailey, March 31, 1994Item Body Image, Depressed Mood, Weight Concerns, and Risky Sexual Behaviors Among Female Adolescents(2006-05-01) Marshall, Khiya J.Marshall, Khiya J., Body Image, Depressed Mood, Weight Concerns, and Risky Sexual Behaviors among Female Adolescents. Doctor of Public Health (Social and Behavioral Sciences), May 2006, 75 pp., 17 tables, bibliography, 90 titles. Adolescence is a time of self-discovery and growth, both emotionally and physically, particularly for adolescent females. The literature lacks specific research pertaining to female adolescent females. The literature lacks specific research pertaining to female adolescent’s body image and other concerns and their association with risky sexual behaviors. Using secondary data from the 2003 Dallas Youth Risk Behavior Survey (YRBS; 9th-12th grade), this study explored the relationship between body image, having a depressed mood, and weight control behaviors and how these may translate into risky sexual behaviors among Dallas Independent School District (DISD) adolescent females. Most respondents were African American and Hispanic. The main hypotheses were: a) African American and Hispanic adolescent females will be more likely to have a depressed mood, an unrealistic body image, or weight control behaviors compared to Caucasian adolescent females; and b) Adolescents with unrealistic body image, depressed mood, and weight control behaviors will be more likely to engage in risky sexual behaviors, regardless of race or ethnicity. As hypothesized, more African American and Hispanic adolescents had a depressed mood, and more Hispanics had an unrealistic body image compared to Caucasians. The hypothesis that depressed mood and unrealistic body image would be significant predictors of engaging in risky sexual behaviors was corroborated only for depressed mood. Engaging in weight control, although hypothesized as not a significant predictor, was a significant predictor for using alcohol/drugs before his last sexual intercourse. School-based sexual education programs that target adolescent females in DISD should focus on abstinence or consistent condom use if sexually active, weight control behaviors, and depressed mood and its implications.Item Clinical Lectures on the Diseases of Women and Children(Samuel S. & William Wood, 1856-01-01) Bedford, Gunning M.D.4th ed., carefully rev. and enl. xvi, [5]-602 p. ; 24 cm.Item COMPARISON OF BODY MASS INDEX PERCENTILE AND PERCENT BODY FAT ON RISK FACTORS FOR TYPE 2 DIABETES MELLITUS IN CHILDREN AGED 10-14(2014-03) Fernando, Shane I.; Fulda, Kimberly; Franks, Susan; Bowman, W. Paul; Shah, Deep; Proffitt-Leyva, Randi; Bawa, Binky; Habiba, NusrathThe growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods: Data were obtained from 290 10-14 year old adolescents who were patients in the pediatrics department of the University of North Texas Health Science Center, patients at Seminary Clinic in Fort Worth and recruited from community events. During study visits, subjects’ BMI percentile and percent body fat were obtained using standard height/weight measurements as well as through the use of a Tanita body composition device. Associations were then assessed using statistical regression models. Results: Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions: The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM. Purpose (a): The growing rate of type 2 diabetes mellitus (T2DM) in children presents a critical public health problem for the future. However, assessment of T2DM risk among children can be challenging. Therefore, to improve assessment of risk, we examined the association between BMIP (body mass index percentile, a traditional indicator) with risk, compared to the association of percent body fat (PBF) with risk. Methods (b): Data were obtained from 290 10-14 year olds in North Central Texas participating in a study examining risk for T2DM. During study visits, subjects’ BMI percentile and percent body fat were obtained using a Tanita body composition device. Associations were then assessed using logistic regression models against four of the five critical risk factors for T2DM: Average blood pressure (BP) above 95th percentile or History of high BP, family history of type 2 diabetes mellitus, positive sign of Acanthosis nigricans and a high blood sugar test. Results (c): Among 290 subjects, 78.2% were of Hispanic origin, with approximately 13.4% being Black. Approximately 51% of subjects were female, while age distribution was evenly spread across 10-14. Logistic regression models found that both PBF and BMIP were significantly associated with Acanthosis nigricans (PBF: Sβ 0.584 vs. BMIP: Sβ 0.489), average systolic BP above 95th percentile (PBF: Sβ 0.219 vs. BMIP: Sβ 0.124), family history of T2DM (PBF: Sβ 0.189 vs. BMIP: Sβ 0.172), and high blood sugar test (PBF: Sβ 0.152 vs. BMIP: Sβ 0.119). Conclusions (d): The data from this study provides evidence that PBF may be a better measurement of T2DM risk among children compared to BMIP. It may be beneficial for pediatric and family physicians to measure PBF alongside BMIP to better ascertain a particular pediatric patient’s risk of T2DM.Item Education of Parents of Newborns with Cleft Lip/Cleft Palate by Healthcare Professionals in Texas Hospitals(2005-05-01) Schimmoller, Mary V.; Sue LurieSchimmoller, Mary V. Education of Parents of Newborns with Cleft Lip/Cleft Palate by Healthcare Professionals in Texas Hospitals. Master of Public Health (Community Health), May 2005, 37 pp., references, 22 titles. The purpose of this study was to ascertain what, how, when and by whom information is given to parents of cleft lip/palate newborns in Texas hospitals and whether additional information is needed. Methods: Telephone interviews with 97 health care professionals who provide initial care to moms of cleft lip/palate newborns in the 159 Texas hospitals with more than 500 live births in 2003/2004. Findings: 76% of respondents said information given to parents of cleft newborns in effective/ very effective, 63% gave conflicting responses on whether babies with cleft can breastfeed, 35% said additional information is needed, 7% said they need information in additional languages. Conclusion: Information given to parents with cleft lip/palate newborns in Texas hospitals is inconsistent and often insufficient.Item Ellis, Virginia, D.O.(1981-02-03) Ellis, Virginia; Stokes, C. Ray“Dr. Virginia” shares her memoirs, which include her involvement in the first Admissions Committee student selections, her progression of committee responsibility and the creation of a Baby Clinic for Fort Worth’s underprivileged children. She discusses TCOM’s contributions to the community, the health care provided by the Mobile Clinic she developed in 1973-74, and the services provided to Fort Worth’s Rehabilitation Farm in 1973-76. She presents a vivid reflection of TCOM’s current contributions to the Fort Worth community’s health resources and services. Interviewed by C. Ray Stokes, February 2-3, 1981.Item Environmental Tobacco Smoke Exposure in Children: Compliance with a Home Smoking Ban Among Texas Households(2007-12-01) Rodriguez, Lori A.; Cardarelli, Kathryn; Ramisetty-Mikler, Suhasini; Lin, Yu-ShengRodriguez, Lori A., Environmental Tobacco Smoke Exposure in Children: Compliance With a Home Smoking Ban Among Texas Households. Master of Public Health (Epidemiology), December, 2007, 72 pp., 10 tables, bibliography, 75 titles. This general population study explores characteristics influencing non-compliance with a home smoking ban among Texas households with children, particularly those with asthmatic children. Over 17% of adults reported non-compliance, with the highest rate in African Americans. Adults who currently smoke (25%) had higher reports of having an asthmatic child in the household and were more likely to not comply. Child asthma status was not a significant predictor of non-compliance; however, African Americans with no asthmatic children were more likely than African Americans with an asthmatic child to not comply. The role of race/ethnicity should be further investigated to improve interventions and home smoking bans should continue to be promoted in an effort to reduce environmental tobacco smoke exposure.Item Evaluation of respiratory outcomes in pre-term infants receiving nCPAP versus surfactant and mechanical ventilation during transport.(2012-12-01) Jacobs, Linda M.; Sumihiro SuzukiThe initial respiratory treatment for premature infants is trending toward nCPAP but this therapy sometimes fails requiring surfactant plus mechanical ventilation. This retrospective review of respiratory interventions by referral hospitals and a neonatal transport team evaluated predictors of respiratory support at 72 hours. A unique variable of time between birth and transport arrival was added to the multivariate regression model. This study confirmed that gestational age and high levels of respiratory support in the first hours of life are strong predictors for higher levels of respiratory support at 72 hours. Time to transport arrival was not a factor. The transport team has trended toward utilizing nCPAP more often over the past two years.Item Exploratory Analysis on the Prevalence of Rapid Growth and Overweight in Normal Weight Infants(2004-06-01) Bell, Karen; Urrutia-Rojas, Ximena; Cipher, Daisha; Menchaca, JohnBell, Karen. Exploratory Analysis on the Prevalence of Rapid Growth and Overweight in Normal Birth Weight Infants. Master of Public Health. June 2004. 33 pp, 5 tables, bibliography, 24 titles. Rapid growth can be defined as a period of growth acceleration that occurs in infants who are born of normal birth weight. Research has shown that children who experience this phenomenon exhibit future health conditions such as cardiovascular disease and obesity. Furthermore, these conditions can manifest in childhood and persist to adulthood. The exploratory study reported here examined rapid growth and overweight in this group. This study also included a review of literature that examined health complications and predictors associated with rapid growth and overweight in this group. This study also included a review of literature that examined health complications and predictors associated with rapid growth. In addition, the author investigated the history of the Centers for Disease Control and Prevention (CDC) growth charts. The exploratory analysis studied data on ninety-one infants from a Cook Children’s Network pediatric office. The infants’ weight and height information were obtained every two months after birth for a six-month time period. This information was used to plot each infant’s growth on 2000 CDC growth charts which would indicate if a child was either growing rapidly, or overweight. Nineteen infants exhibited rapid growth within the first six to nine months of life. Eight were found to be either obese, overweight or at risk of being overweight. The health complications associated with rapid growth in these infants needs to be assessed. Therefore, it is important that more research is performed that examines this phenomenon.Item Impact Analysis of Texas Child Fatality Review Teams on Incidence and Select Cause of Death Determination(2000-12-01) Migala, Witold M.; Doug A. MainsMigala, Witold M., Impact Analysis of Texas Child Fatality Review Teams on Incidence and Select Cause of Death Determination. Doctor of Philosophy (Biomedical Sciences), December 2000, 136 pp., 14 tables, reference list, 107 titles. To examine the impact of Child Fatality Review Teams (CFRT) on the overall death rates of children in Texas, those counties with CFRT representation were compared to counties without representation. Death rates for Sudden Infant Death Syndrome (SIDS) and rates for death due to abuse, classified by ICD-9 coding, were also compared marked by CFRT representation. The Texas Department of Health’s Epigram database was used to collect death rate data. Age-adjusted death rates by gender, race/ethnicity, age group and cause of death were established for the five countries with CFRTs initiated in 1992; the two countries with teams initiated in 1993; and the 56 countries with teams initiated in 1994. These were compared to the death rates of counties without CFRT representation for the same years. Analyses were conducted by using t-tests, chi-square, and ARIMA statistics, and calculations of odds ratios and confidence intervals. The results of the inferential tests suggest that CFRT representation had a protective effect on children’s death rates contingent on the longevity of representation. Additional research regarding impact evaluation of multidisciplinary team representation on the incidence and rate of children’s deaths is recommended.Item Potential Predictors of Hypertension Among Children in Fort Worth, Texas: A Cross-Sectional Epidemiologic Study(2002-05-01) Egbuchunam, Christie U.; Bayona, Manuel; Urrutia-Rojas, Ximena; Wilkinson, GreggEgbuchunam, Christie U., Potential Predictors of Hypertension Among Children in Fort Worth, Texas; A Cross-Sectional Epidemiologic Study. Master of Public Health (Epidemiology), May, 2002, 110 pp., 15 tables, 2 illustrations, bibliography, 84 titles. Most studies have identified obesity, gender and age as major factors that influence blood pressure increase in children. The objective of this study was to assess factors that may either directly influence hypertension in children, or interact with obesity, age and gender. A cross-sectional study was carried out to identify and assess the crude and multiple logistic regression adjusted associations between selected variables and hypertension. Obesity and Acanthosis Nigricans (AN) were importantly associated with hypertension. Reduced playing time, and excessive television watching or playing of video games were also associated with hypertension; especially among those who were obese or had AN. Hispanic and African American children had higher likelihood of hypertension than Caucasian children.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 SEVERE HYPONATREMIA IN AN INFANT WITH PSEUDOHYPOALDOSTERONISM(2014-03) Douglass, Matthew; Wilson, Don; Fiocchi, Casey; Dallas, John; Radack, JillPurpose (a): The purpose of this project is to present an interesting case of severe hyponatremia in an infant with pseudohypoaldosteronism and present information about the disease Pseudohypoaldosteronism including: definition, characteristics, etiology, presentation, management, and prognosis. Methods (b): Materials consist of a single patient’s records and methods consist of review of those records and a thorough review of published literature on Pseudohypoaldosteronism as available on Pubmed. Results (c): The patient was found to have a previously unidentified mutation in the genes known to be associated with autosomal dominant form of Pseudohypoaldosteronism and has required supplemental sodium of 11 mEq/kg/day in addition to a low potassium diet and potassium binding agents to make up for renal losses of sodium and hyperkalemia due to his disease. Conclusions (d): This patient has a novel gene mutation causing his disease and has required treatment of persistent electrolyte abnormalities by sodium supplements and potassium binding agents.Item Study of Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia (All)(2013-05-01) Bhat, Nikhil U.; Jerry SimeckaThe number of childhood cancer survivors has dramatically increased over the last two decades (1, 2). Survivorship programs focus on the health problems childhood cancer survivors face because of their cancer treatments. These programs provide surveillance for health problems, and educate survivors about their risk for health problems, to encourage them to engage in activities to minimize the development of severe health related problems. Clinicians perceive there to be a problem of increasing obesity among leukemia survivors. Obesity should not be considered simply a consequence of an unhealthy lifestyle: it is a condition in which weight gain has reached the point where it poses significant risks to health (3). The use of chemotherapy agents such as anthracyclines and radiation (to the thorax) are associated with cardiovascular disease (4, 5, 6). Obesity in cancer survivors is not yet well understood but may further increase cardiovascular risks. Cancer treatments, lifestyles, and medications other than chemotherapy may contribute to obesity among cancer survivors. Survivors of acute lymphoblastic leukemia (ALL) may be more likely to develop obesity or cardiovascular diseases due to their cancer treatments, which include chemotherapy, steroids, and sometimes radiotherapy (7). Strategies to reduce obesity in ALL survivors include a multifaceted approach, drug therapy and interventions to address psychological problems, as well as lifestyle modifications (7, 8). This practicum project examined obesity as an adverse health condition among survivors of childhood ALL. Considering the fact that the there are various factors which may lead to obesity among cancer survivors and all are not proven yet, this practicum project examined whether the type of treatment and the medications given to the patients contributed to the changes in BMI in 2 the patients. The project also evaluated trends in Body Mass Index (BMI) among patients at each time points and the changes in BMI with respect to variables like ethnicity. The objective of this study was to evaluate these trends was to use a database to determine the frequency of obesity among ALL survivors and thereby get some concrete information as to how the type of treatment affected the BMI in the group of patients who were considered for the study and whether there was a trend related to changes in BMI seen in a specific ethnic group which was part of the study. Since obesity is a major risk factor among ALL survivors, steps need to be taken to reduce its threat not only among survivors but also among other people in the community. This project was a step taken in that direction to combat the threat of obesity among ALL survivors.Item Synergy 2008: Annual Research Report(2008-01-01)Item Synergy 2010: Annual Research Report(2010-01-01)