Community Medicine

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    (2014-03) Septien, Spencer J.; David, Jonathan; Kjolhede, Lauren; Sims, Meagan
    The purpose of this investigation was to identify comprehensive community resources available in the Tarrant County area for people diagnosed with Alzheimer’s disease (AD). AD is a debilitating illness that requires lifelong care and support. There is currently no cure for AD making community resources an invaluable asset to any person afflicted with the disease. Our goal was to educate the community on the basics of AD and to identify local resources which could help patients and their families cope with the effects and burdens of AD. Our group conducted research using to locate organizations within Tarrant County that offer a variety of comprehensive resources for individuals with AD. We analyzed the services provided by the Alzheimer’s Association- North Texas Chapter, Memories in the Making, James L. West Alzheimer’s Center, and the Texas Alzheimer’s Research and Care Consortium. The Alzheimer’s Association- North Texas Chapter should be the primary resource for local residents afflicted with AD. The organization offers support, education, and programs such as TrialMatch and professional training. TrialMatch is a free program designed to locate clinical trials for people suffering from AD using one’s unique diagnosis and symptoms. Professional training for medical personnel helps educate caretakers on the proper way to care for this unique subset of the population. Memories in the Making is an organization that offers a therapeutic outlet for AD patients by allowing individuals to express themselves through art and exercises that stimulate creativity. The James L. West Alzheimer’s Center is a comprehensive care center offering activities, education, and specialized care for any stage of the disease. The Texas Alzheimer’s Research and Care Consortium is a large statewide research project that strives to better understand the disease by examining the potential role of genetic factors and phenotypic characteristics of subjects in the epidemiology and pathology of AD. Tarrant County has a variety of services available to patients and families coping with Alzheimer’s disease and its effects. These services are aimed at education, support, and research with the ultimate goal of decreasing the morbidity and mortality of those individuals suffering with Alzheimer’s disease.
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    (2014-03) Leber, Julie; DeHaven, Mark
    Purpose (a): A balanced diet and good nutrition help maintain a strong immune system for resisting disease and contribute to improved quality of life. Weight loss, wasting, and malnutrition are common problems which can contribute to HIV disease progression. With recent advances in effective antiretroviral medications, good nutrition can help those infected with HIV to better process their many medications. Diet (and exercise) may help control other symptoms such as diarrhea, nausea, and fatigue, and other metabolic abnormalities such as high blood sugar, cholesterol, and triglycerides. The purpose of this project was to assess the behaviors, knowledge, and attitudes related to modifiable lifestyle factors for improving health outcomes among residents of an HIV/AIDS living facility in Fort Worth (Samaritan House). This study will provide the baseline for understanding the potential value in making future nutritional interventions within the living facility. Methods (b): The Samaritan House in Fort Worth is dedicated to creating a supportive community providing housing and resources for positive change in the lives of persons living with HIV/AIDS and other special needs. A conglomerate of validated questionnaires was administered to Samaritan House residents in order to assess their knowledge, attitudes, and behaviors with regards to nutrition, physical activity, depression, and smoking. Results (c): Results showed that residents intake patterns did not meet the dietary recommendations with regards to fat, fruits, vegetables, and fiber, and that the majority of residents worry considerably about their health but do not change their eating habits because of it. The majority of residents answered that motivations for healthy behavior were driven by internal rather than external factors. 64% screened positive for depression. 54% were active smokers, but 41% had tried to quit in the past year. With regards to physical activity, 33% of residents had a high level, 33% had a medium level, and 33% had a low level. Conclusions (d): Nutritional and lifestyle renovation are a potential source of improvement at Samaritan House. This results of this study will be used to provide a foundation by which later studies can be conducted that examine the effects of dietary interventions (through education and influence of the charitable donations providing food) on the holistic health of this population, which will serve to improve the quality of life and prevention of disease.
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    (2014-03) Akinbola, Ebunoluwa E.; Allen, Ryan; Shi, Xiangrong
    Purpose (a): The purpose of this study was to investigate neighborhood factors on children's physical activity and dietary habits and to test the hypothesis that lifestyle behaviors would be more critical than neighborhood environment in determining children's health status. Methods (b): We analyzed 2,930 school children whose parents participated in Community-wide Children's Health Assessment & Planning Survey in 6 north-Texas counties. Neighborhood factors focused on "are there grocery stores in your neighborhood that have fresh fruit and vegetables" and "are there safe parks/outdoor areas for the child to play in your neighborhood". Body mass index percentile (BMI-PCT) was determined to categorize normal weight (BMI-PCTthis child typically eats healthy meals". The chi-square test was applied, and the logistic regression model was used to predict children's health status and BMI-PCT. Results (c): If there were no "grocery-stores" in the neighborhood, the proportions of children who took unhealthy meals increased from 19.8% to 29.3% (P =0.042) and who were overweight-obese increased from 30.4% to 44.0% (P =0.017). If there were no "safe parks/outdoor areas" in the neighborhood, physically active children decreased from 77.0% to 69.9% (Pgrocery-stores"(P =0.020) and healthy dietary choice (P =0.032). Their health status was associated with healthy dietary choices (P <0.0001), PA levels (P <0.0001), and "safe parks/outdoor areas" (P <0.0001) and negatively correlated with BMI-PCT (P =0.007). Conclusions (d): Neighborhood factors significantly influence children's PA levels, dietary choices, overweight-obese rate and health status. However, healthy lifestyles are more important than environmental factors for children's health status. Physical activity is the number 1 determinant for children's weight problem.
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    (2014-03) Fulda, Kimberly G.; Kurian, Anita K.; Balyakina, Elizabeth S.; Moerbe, Micky M.
    Low birth weight, including very low birth weight (<1,500 grams), is not evenly distributed across racial/ethnic groups. Although the reason for this is not completely understood, recent research has emphasized the need for a more comprehensive understanding of paternal influences on racial/ethnic birth disparities. This study looked at the association between paternal race/ethnicity and very low birth weight (VLBW) stratified by maternal race/ethnicity. Results show that paternal race/ethnicity is an important predictor of VLBW among white and Hispanic mothers. Future research should consider paternal race/ethnicity and further explore the association between paternal characteristics and VLBW. Purpose (a): The purpose was to examine the association between paternal race/ethnicity and VLBW stratified by maternal race/ethnicity. Methods (b): Birth data for Tarrant County, Texas 2006-2010 were analyzed. VLBW was dichotomized as yes (<1,500g) and no (≥1,500g). Paternal race/ethnicity was categorized as white, African American (AA), Hispanic, other, and missing. Missing observations (14.7%) were included and served as a proxy for fathers absent during pregnancy. Potential confounders included maternal age, education, and marital status, plurality, previous preterm birth, sexually transmitted disease during pregnancy, smoking during pregnancy, and Kotelchuck Index of prenatal care. Logistic regressions were stratified by maternal race/ethnicity. Odds ratios and 95% confidence intervals were calculated. Results (c): Of 145,054 births, 60,156 (41.5%) were white, 22,306 (15.4%) AA, 54,553 (37.6%) Hispanic, and 8,039 (5.5%) other mothers. There were 2,154 (1.5%) VLBWs total, with 3.1% for AA mothers and 1.2% for all other race/ethnicities. Among white mothers, AA paternal race was associated with increased odds of VLBW (OR=1.52; 95% CI:1.08-2.14). Among Hispanic mothers, AA paternal race (OR=1.66; 95% CI:1.01-2.74) and missing paternal race/ethnicity (OR=1.65; 95% CI:1.15-2.36) were associated with increased odds of VLBW. Conclusions (d): Paternal race/ethnicity is an important predictor of VLBW among white and Hispanic mothers. Future research should consider paternal race/ethnicity and further explore the association between paternal characteristics and VLBW.