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1.
Artículo en Inglés | MEDLINE | ID: mdl-34067291

RESUMEN

As COVID-19 run rampant in high-density housing sites, it is important to use real-time data in tracking the virus mobility. Emerging cluster detection analysis is a precise way of blunting the spread of COVID-19 as quickly as possible and save lives. To track compliable mobility of COVID-19 on a spatial-temporal scale, this research appropriately analyzed the disparities between spatial-temporal clusters, expectation maximization clustering (EM), and hierarchical clustering (HC) analysis on Texas county-level. Then, based on the outcome of clustering analysis, the sensitive counties are Cottle, Stonewall, Bexar, Tarrant, Dallas, Harris, Jim hogg, and Real, corresponding to Southeast Texas analysis in Geographically Weighted Regression (GWR) modeling. The sensitive period took place in the last two quarters in 2020 and the first quarter in 2021. We explored PostSQL application to portray tracking Covid-19 trajectory. We captured 14 social, economic, and environmental impact's indices to perform principal component analysis (PCA) to reduce dimensionality and minimize multicollinearity. By using the PCA, we extracted five factors related to mortality of COVID-19, involved population and hospitalization, adult population, natural supply, economic condition, air quality or medical care. We established the GWR model to seek the sensitive factors. The result shows that adult population, economic condition, air quality, and medical care are the sensitive factors. Those factors also triggered high increase of COVID-19 mortality. This research provides geographical understanding and solution of controlling COVID-19, reference of implementing geographically targeted ways to track virus mobility, and satisfy for the need of emergency operations plan (EOP).


Asunto(s)
COVID-19 , Adulto , Humanos , Análisis de Regresión , SARS-CoV-2 , Regresión Espacial , Texas/epidemiología
2.
BMC Public Health ; 21(1): 976, 2021 05 25.
Artículo en Inglés | MEDLINE | ID: mdl-34034711

RESUMEN

BACKGROUND: Hispanic immigrants continue to experience higher rates of overweight and obesity compared to their non-Hispanic counterparts. Acculturation may contribute to unhealthy weight gain among immigrant populations by shifting dietary patterns from high fruit and vegetable consumption to unhealthier high fat diets. Healthy Fit, a culturally tailored community health worker (CHW) intervention, aims to reduce obesity related outcomes by providing physical activity and nutrition education and resources in a low-income Hispanic population. This study aims to evaluate outcomes of Healthy Fit participants and examine changes in body composition in relation to level of acculturation at baseline and follow-up. METHOD: In this longitudinal observational study, CHWs recruited 514 participants from community events and agencies serving low-income Hispanic populations in El Paso, Texas from 2015 to 2016. Following an in-person health screening, eligible participants received nutrition and physical activity education guided by fotonovelas, comic-like educational books. Telephone follow-ups made at 1, 3, and 6 months by CHWs encouraged follow-through on referrals. 288 participants completed the screening again during the 12-month follow-up. RESULTS: The sample was predominantly Hispanic (96%), female (82%), uninsured (79%), had a household income of less than $19,999 (70%), foreign-born (79%), preferred Spanish (86%) and few rated themselves as good or excellent for English proficiency (27%). Overall, Healthy Fit participants significantly improved (i.e., decreased) BFP by 0.71% (t = 2.47, p = 0.01) but not BMI (b = .01, t = - 0.14, p = .89). Contrary to expectations, acculturation was not associated with lower BMI (b = 0.09, p = 0.84) or BFP (b = 0.13, p = 0.85) at baseline. However, acculturation predicted changes in both BMI (b = 0.30, p = 0.03) and BFP (b = 1.33, p = 0 .01) from baseline to follow-up. Specifically, the low acculturation group improved in body composition measures over time and the high acculturation group did not improve in either measure. CONCLUSION: Findings suggest Healthy Fit was most effective among less acculturated individuals. The influence of acculturation on the efficacy of nutrition and exercise interventions suggests that Hispanics should not be treated as a homogenous subgroup.


Asunto(s)
Aculturación , Americanos Mexicanos , Composición Corporal , Femenino , Hispanoamericanos , Humanos , México , Texas/epidemiología
3.
JMIR Public Health Surveill ; 7(4): e26720, 2021 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-33847587

RESUMEN

BACKGROUND: The ongoing COVID-19 pandemic is characterized by different morbidity and mortality rates across different states, cities, rural areas, and diverse neighborhoods. The absence of a national strategy for battling the pandemic also leaves state and local governments responsible for creating their own response strategies and policies. OBJECTIVE: This study examines the content of COVID-19-related tweets posted by public health agencies in Texas and how content characteristics can predict the level of public engagement. METHODS: All COVID-19-related tweets (N=7269) posted by Texas public agencies during the first 6 months of 2020 were classified in terms of each tweet's functions (whether the tweet provides information, promotes action, or builds community), the preventative measures mentioned, and the health beliefs discussed, by using natural language processing. Hierarchical linear regressions were conducted to explore how tweet content predicted public engagement. RESULTS: The information function was the most prominent function, followed by the action or community functions. Beliefs regarding susceptibility, severity, and benefits were the most frequently covered health beliefs. Tweets that served the information or action functions were more likely to be retweeted, while tweets that served the action and community functions were more likely to be liked. Tweets that provided susceptibility information resulted in the most public engagement in terms of the number of retweets and likes. CONCLUSIONS: Public health agencies should continue to use Twitter to disseminate information, promote action, and build communities. They need to improve their strategies for designing social media messages about the benefits of disease prevention behaviors and audiences' self-efficacy.


Asunto(s)
/epidemiología , Pandemias , Salud Pública , Medios de Comunicación Sociales/estadística & datos numéricos , Humanos , Procesamiento de Lenguaje Natural , Texas/epidemiología
4.
Vaccine ; 39(21): 2857-2866, 2021 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-33896664

RESUMEN

INTRODUCTION: Vaccination helps to prevent influenza infection and reduce associated costs but the influenza vaccination rate in Texas for adults between the ages of 18 to 64 years old is the lowest in the US. Pharmacies and alternative locations have been shown to help increase vaccination rates but many adults still go unvaccinated. OBJECTIVE: This research aims to determine the factors associated with obtaining influenza vaccination at the pharmacy compared to non-pharmacy locations in Texas. METHOD: This study used pooled Texas Behavior Risk Factor Surveillance System datasets (2014 to 2018) for this assessment. The main outcome variable was categorized into pharmacy and non-pharmacy vaccination locations and analyzed using a logistic regression analysis. Further statistical analysis was done using a multinomial logistic regression after re-categorizing the outcome variable into pharmacy, doctor office, and other locations. RESULT: Blacks were 63% (AOR 0.37, C.I. 0.26, 0.50) and Hispanics were 38% (AOR 0.62, C.I. 0.48, 0.80) less likely to receive influenza vaccinations at the pharmacy respectively when compared to Whites. Furthermore, those who did not live in a Metropolitan Statistical Area (MSA) were 33% (AOR 0.67, C.I 0.53, 0.84) less likely to receive influenza vaccinations at the pharmacy compared to those who lived in an MSA. While there was no observed difference in the likelihood of receiving influenza vaccination, the unemployed population were 40% (AOR 1.40, C.I 1.15, 1.71) more likely to be vaccinated in the pharmacy compared to the employed population. CONCLUSION: There is potential for increased utilization of pharmacies as a source of influenza vaccination in Texas. Racial differences exist both for receiving influenza vaccinations and being vaccinated in the pharmacy. Influenza vaccination advocacy and education efforts may be necessary to improve pharmacy-based vaccination in Texas, especially for minorities and rural-dwelling Texans.


Asunto(s)
Vacunas contra la Influenza , Gripe Humana , Farmacias , Farmacia , Adolescente , Adulto , Sistema de Vigilancia de Factor de Riesgo Conductual , Humanos , Gripe Humana/prevención & control , Persona de Mediana Edad , Texas/epidemiología , Vacunación , Adulto Joven
5.
JAMA Netw Open ; 4(4): e215854, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33852002

RESUMEN

Importance: Ensuring access to prenatal care services in the US is challenging, and implementation of telehealth options was limited before the COVID-19 pandemic, especially in vulnerable populations, given the regulatory requirements for video visit technology. Objective: To explore the association of audio-only virtual prenatal care with perinatal outcomes. Design, Setting, and Participants: This cohort study compared perinatal outcomes of women who delivered between May 1 and October 31, 2019 (n = 6559), and received in-person prenatal visits only with those who delivered between May 1 and October 31, 2020 (n = 6048), when audio-only virtual visits were integrated into prenatal care during the COVID-19 pandemic, as feasible based on pregnancy complications. Parkland Health and Hospital System in Dallas, Texas, provides care to the vulnerable obstetric population of the county via a high-volume prenatal clinic system and public maternity hospital. All deliveries of infants weighing more than 500 g, whether live or stillborn, were included. Exposures: Prenatal care incorporating audio-only prenatal care visits. Main Outcomes and Measures: The primary outcome was a composite of placental abruption, stillbirth, neonatal intensive care unit admission in a full-term (≥37 weeks) infant, and umbilical cord blood pH less than 7.0. Visit data, maternal characteristics, and other perinatal outcomes were also examined. Results: The mean (SD) age of the 6559 women who delivered in 2019 was 27.8 (6.4) years, and the age of the 6048 women who delivered in 2020 was 27.7 (6.5) years (P = .38). Of women delivering in 2020, 1090 (18.0%) were non-Hispanic Black compared with 1067 (16.3%) in 2019 (P = .04). In the 2020 cohort, 4067 women (67.2%) attended at least 1 and 1216 women (20.1%) attended at least 3 audio-only virtual prenatal visits. Women who delivered in 2020 attended a greater mean (SD) number of prenatal visits compared with women who delivered in 2019 (9.8 [3.4] vs 9.4 [3.8] visits; P < .001). In the 2020 cohort, 173 women (2.9%) experienced the composite outcome, which was not significantly different than the 195 women (3.0%) in 2019 (P = .71). In addition, the rate of the composite outcome did not differ substantially when examined according to the number of audio-only virtual visits attended. Conclusions and Relevance: Implementation of audio-only virtual prenatal visits was not associated with changes in perinatal outcomes and increased prenatal visit attendance in a vulnerable population during the COVID-19 pandemic when used in a risk-appropriate model.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Adulto , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Atención Prenatal/métodos , Texas/epidemiología
7.
Am J Pathol ; 191(6): 983-992, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33741335

RESUMEN

Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, there has been international concern about the emergence of virus variants with mutations that increase transmissibility, enhance escape from the human immune response, or otherwise alter biologically important phenotypes. In late 2020, several variants of concern emerged globally, including the UK variant (B.1.1.7), the South Africa variant (B.1.351), Brazil variants (P.1 and P.2), and two related California variants of interest (B.1.429 and B.1.427). These variants are believed to have enhanced transmissibility. For the South Africa and Brazil variants, there is evidence that mutations in spike protein permit it to escape from some vaccines and therapeutic monoclonal antibodies. On the basis of our extensive genome sequencing program involving 20,453 coronavirus disease 2019 patient samples collected from March 2020 to February 2021, we report identification of all six of these SARS-CoV-2 variants among Houston Methodist Hospital (Houston, TX) patients residing in the greater metropolitan area. Although these variants are currently at relatively low frequency (aggregate of 1.1%) in the population, they are geographically widespread. Houston is the first city in the United States in which active circulation of all six current variants of concern has been documented by genome sequencing. As vaccine deployment accelerates, increased genomic surveillance of SARS-CoV-2 is essential to understanding the presence, frequency, and medical impact of consequential variants and their patterns and trajectory of dissemination.


Asunto(s)
COVID-19 , Mutación , Pandemias , SARS-CoV-2/genética , COVID-19/epidemiología , COVID-19/genética , COVID-19/transmisión , Femenino , Humanos , Masculino , SARS-CoV-2/aislamiento & purificación , Texas/epidemiología
8.
J Parasitol ; 107(1): 138-140, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33647983

RESUMEN

Quail populations in the United States have been declining for several decades, and the role that parasites may be playing in this decline is not well understood. The goal of this study was to document novel parasites that inhabited the scaled quail, Callipepla squamata, of the Trans-Pecos ecoregion of Texas. To do this, quail were collected by hunter-harvest, night-netting, and funnel-trapping and were necropsied in the laboratory to determine the parasites they hosted. After analyzing 386 birds, we identified Dispharynx sp. in one of the samples. This specimen is the first to be officially documented in scaled quail.


Asunto(s)
Enfermedades de las Aves/parasitología , Codorniz/parasitología , Infecciones por Spirurida/veterinaria , Spirurina/aislamiento & purificación , Animales , Enfermedades de las Aves/epidemiología , Enfermedades de las Aves/patología , Proventrículo/parasitología , Proventrículo/patología , Infecciones por Spirurida/epidemiología , Infecciones por Spirurida/parasitología , Infecciones por Spirurida/patología , Spirurina/clasificación , Texas/epidemiología
9.
J Parasitol ; 107(1): 132-137, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33647985

RESUMEN

The Northern bobwhite quail (Colinus virginianus) is a popular game bird that has been experiencing a well-documented decline throughout Texas since the 1960s. While much of this decline has been attributed to habitat loss and fragmentation, recent studies have identified other factors that may also contribute to decreasing quail populations. Parasites, in particular, have become increasingly recognized as possible stressors of quail, and some species, particularly the eyeworm (Oxyspirura petrowi) and cecal worm (Aulonocephalus pennula) are highly prevalent in Texas quails. Eyeworm infection has also been documented in some passerines, suggesting helminth infection may be shared between bird species. However, the lack of comprehensive helminth surveys has rendered the extent of shared infection between quail and passerines in the ecoregion unclear. Thus, helminth surveys were conducted on bobwhite, scaled quail (Callipepla squamata), Northern mockingbirds (Mimus polyglottos), curve-billed thrashers (Toxistoma curvirostre), and Northern cardinals (Cardinalis cardinalis) to contribute data to existing parasitological gaps for birds in the Rolling Plains ecoregion of Texas. Birds were trapped across 3 counties in the Texas Rolling Plains from March to October 2019. Necropsies were conducted on 54 individuals (36 quail and 18 passerines), and extracted helminths were microscopically identified. Nematode, cestode, and acanthocephalan helminths representing at least 10 helminth species were found. Specifically, A. pennula and O. petrowi had the highest prevalence, and O. petrowi was documented in all of the study species. This research adds to the body of knowledge regarding parasitic infections in quail and passerines of the Rolling Plains ecoregion and highlights the potential consequences of shared infection of eyeworms among these bird species.


Asunto(s)
Enfermedades de las Aves/parasitología , Chromadorea/aislamiento & purificación , Colinus/parasitología , Helmintiasis Animal/parasitología , Passeriformes/parasitología , Thelazioidea/aislamiento & purificación , Animales , Enfermedades de las Aves/epidemiología , Chromadorea/clasificación , Infecciones Parasitarias del Ojo/epidemiología , Infecciones Parasitarias del Ojo/parasitología , Infecciones Parasitarias del Ojo/veterinaria , Helmintiasis Animal/epidemiología , Prevalencia , Infecciones por Spirurida/epidemiología , Infecciones por Spirurida/parasitología , Infecciones por Spirurida/veterinaria , Texas/epidemiología , Thelazioidea/clasificación
10.
Value Health ; 24(3): 361-368, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33641770

RESUMEN

OBJECTIVES: Promoting patient involvement in managing co-occurring physical and mental health conditions is increasingly recognized as critical to improving outcomes and controlling costs in this growing chronically ill population. The main objective of this study was to conduct an economic evaluation of the Wellness Incentives and Navigation (WIN) intervention as part of a longitudinal randomized pragmatic clinical trial for chronically ill Texas Medicaid enrollees with co-occurring physical and mental health conditions. METHODS: The WIN intervention used a personal navigator, motivational interviewing, and a flexible wellness expense account to increase patient activation, that is, the patient's knowledge, skills, and confidence in managing their self-care and co-occurring physical and mental health conditions. Regression models were fit to both participant-level quality-adjusted life years (QALYs) and total costs of care (including the intervention) controlling for demographics, health status, poverty, Medicaid managed care plan, intervention group, and baseline health utility and costs. Incremental costs and QALYs were calculated based on the difference in predicted costs and QALYs under intervention versus usual care and were used to calculate the incremental cost-effectiveness ratios (ICERs). Confidence intervals were calculated using Fieller's method, and sensitivity analyses were performed. RESULTS: The mean ICER for the intervention compared with usual care was $12 511 (95% CI $8971-$16 842), with a sizable majority of participants (70%) having ICERs below $40 000. The WIN intervention also produced higher QALY increases for participants who were sicker at baseline compared to those who were healthier at baseline. CONCLUSION: The WIN intervention shows considerable promise as a cost-effective intervention in this challenging chronically ill population.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/organización & administración , Medicaid/estadística & datos numéricos , Afecciones Crónicas Múltiples/epidemiología , Adulto , Análisis Costo-Beneficio , Femenino , Promoción de la Salud/economía , Estado de Salud , Humanos , Estudios Longitudinales , Masculino , Medicaid/economía , Entrevista Motivacional/organización & administración , Navegación de Pacientes/organización & administración , Años de Vida Ajustados por Calidad de Vida , Autocuidado , Autoimagen , Factores Socioeconómicos , Texas/epidemiología , Estados Unidos , Adulto Joven
11.
MMWR Morb Mortal Wkly Rep ; 70(10): 348-349, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33705368

RESUMEN

In December 2020, the B.1.1.7 genetic variant of SARS-CoV-2, the virus that causes COVID-19, was first reported after emergence and rapid circulation in the United Kingdom (1). Evidence suggests that the B.1.1.7 variant is more efficiently transmitted than are other SARS-CoV-2 variants, and widespread circulation could thereby increase SARS-CoV-2 infection and hospitalization rates (1,2). The first reported SARS-CoV-2 B.1.1.7 variant case in the United States was confirmed by sequencing in Colorado on December 29, 2020.* This report describes a person who traveled from the United Kingdom to the United States after experiencing COVID-19-compatible symptoms† and was eventually confirmed to be infected with the B.1.1.7 variant.


Asunto(s)
/diagnóstico , /aislamiento & purificación , Enfermedad Relacionada con los Viajes , /complicaciones , Humanos , Persona de Mediana Edad , Evaluación de Síntomas , Texas/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiología
12.
J Stroke Cerebrovasc Dis ; 30(6): 105727, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33761450

RESUMEN

OBJECTIVES: We explored how the new, tissue-based stroke definition impacted incidence estimates, including an ethnic comparison, in a population-based study. METHODS: Stroke patients, May, 2014-May, 2016 in Nueces County, Texas were ascertained and validated using source documentation. Overall, ethnic-specific and age-specific Poisson regression models were used to compare first-ever ischemic stroke and intracerebral hemorrhage (ICH) incidence between old and new stroke definitions, adjusting for age, ethnicity, sex, and National Institutes of Health Stroke Scale score. RESULTS: Among 1308 subjects, 1245 (95%) were defined as stroke by the old definition and 63 additional cases (5%) according to the new. There were 12 cases of parenchymal hematoma (PH1 or PH2) that were reclassified from ischemic stroke to ICH. Overall, incidence of ischemic stroke was slightly higher under the new compared to the old definition (RR 1.07; 95% CI 0.99-1.16); similarly higher in both Mexican Americans (RR 1.06; 95% CI 1.00-1.12) and Non Hispanic whites (RR 1.09, 95% CI 0.97-1.22), p(ethnic difference)=0.36. Overall, incidence of ICH was higher under the new definition compared to old definition (RR 1.16; 95% CI 1.05-1.29), similarly higher among both Mexican Americans (RR 1.14; 95% CI 1.06-1.23) and Non Hispanic whites (RR 1.20, 95% CI 1.03-1.39), p(ethnic difference)=0.25. CONCLUSION: Modest increases in ischemic stroke and ICH incidence occurred using the new compared with old stroke definition. There were no differences between Mexican Americans and non Hispanic whites. These estimates provide stroke burden estimates for public health planning.


Asunto(s)
Grupo de Ascendencia Continental Europea , /etnología , Americanos Mexicanos , Terminología como Asunto , Anciano , Femenino , Necesidades y Demandas de Servicios de Salud , /diagnóstico , Humanos , Incidencia , /diagnóstico , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Factores Raciales , Medición de Riesgo , Factores de Riesgo , Texas/epidemiología
13.
Int J Infect Dis ; 105: 252-255, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33610788

RESUMEN

We implemented universal face shield use for all healthcare personnel upon entry to facility in order to counter an increase in SARS-COV2 cases among healthcare personnel and hospitalized patients. There was a marked reduction of infections in both healthcare personnel and hospitalized patients between pre and post intervention. Our results support universal face shield use as part of a multifaceted approach in areas of high SARS-COV2 community transmission.


Asunto(s)
/diagnóstico , Personal de Salud/estadística & datos numéricos , Enfermedad Iatrogénica/prevención & control , Pacientes Internos/estadística & datos numéricos , Humanos , Análisis de Series de Tiempo Interrumpido , Máscaras , Equipo de Protección Personal , Texas/epidemiología
14.
PLoS Negl Trop Dis ; 15(2): e0009147, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33600455

RESUMEN

The causative agent of Chagas disease, Trypanosoma cruzi, is transmitted by triatomine vectors. The insect is endemic in the Americas, including the United States, where epidemiological studies are limited, particularly in the Southwestern region. Here, we have determined the prevalence of T. cruzi in triatomines, feral cats and dogs, and wild animals, the infecting parasite genotypes and the mammalian host bloodmeal sources of the triatomines at four different geographical sites in the U.S.-Mexico border, including El Paso County, Texas, and nearby cities in New Mexico. Using qualitative polymerase chain reaction to detect T. cruzi infections, we found 66.4% (n = 225) of triatomines, 45.3% (n = 95) of feral dogs, 39.2% (n = 24) of feral cats, and 71.4% (n = 7) of wild animals positive for T. cruzi. Over 95% of T. cruzi genotypes or discrete typing units (DTUs) identified were TcI and some TcIV. Furthermore, Triatoma rubida was the triatomine species most frequently (98.2%) collected in all samples analyzed. These findings suggest a high prevalence of T. cruzi infections among triatomines, and feral and wild animals in the studied sites. Therefore, our results underscore the urgent need for implementation of a systematic epidemiological surveillance program for T. cruzi infections in insect vectors, and feral and wild animals, and Chagas disease in the human population in the southwestern region of the United States.


Asunto(s)
Enfermedad de Chagas/veterinaria , Triatoma/parasitología , Trypanosoma cruzi/aislamiento & purificación , Animales , Animales Salvajes/parasitología , Gatos , Enfermedad de Chagas/epidemiología , Perros , Conducta Alimentaria , Humanos , Insectos Vectores/parasitología , Mamíferos , New Mexico/epidemiología , Texas/epidemiología
15.
Addict Behav ; 117: 106850, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33582623

RESUMEN

OBJECTIVES: This study examines the relationships between recall of exposure to digital marketing of smokeless tobacco, via the internet and social media, and subsequent initiation of smokeless tobacco use at one-year follow-up, among young adult never users of smokeless tobacco in Texas. METHODS: Data were from waves 6 (Spring 2017) and 7 (Spring 2018) of the Marketing and Promotions Across Colleges in Texas Study (Project M-PACT); a longitudinal study of two- and four-year Texas college students. Participants were 2731 young adult never smokeless tobacco users (ages 20-32) with complete data at both assessment periods. A multi-level, multiple logistic regression model was applied, accounting for school clustering, to examine the relationship between recall of exposure to digital marketing of smokeless tobacco at baseline (wave 6) and smokeless tobacco use initiation at one-year follow-up (wave 7). Analyses controlled for important baseline covariates (socio-demographic factors, other marketing exposure, other tobacco product use). RESULTS: Overall, 14.6% of never smokeless tobacco users reported exposure to smokeless tobacco marketing via digital media. Exposure to digital marketing of smokeless tobacco at baseline was associated with greater odds of smokeless tobacco use initiation among young adult never users (AOR: 2.14; 95%CI: 1.12 - 4.06) at one-year follow-up. CONCLUSIONS: Findings reveal exposure to smokeless tobacco marketing via digital media was common. Further, there appears to be a strong relationship between this exposure and subsequent smokeless tobacco use among young adult never smokeless tobacco users.


Asunto(s)
Productos de Tabaco , Tabaco sin Humo , Adulto , Humanos , Internet , Estudios Longitudinales , Mercadotecnía , Texas/epidemiología , Adulto Joven
16.
AIDS Patient Care STDS ; 35(2): 39-46, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33571047

RESUMEN

Viral suppression and postpartum retention in care have far-reaching health implications for pregnant women living with HIV and their children, yet remain public health challenges. Prenatal care presents a unique opportunity to engage pregnant women in care. The purpose of this study is to evaluate whether group prenatal care is effective in impacting these outcomes for pregnant women living with HIV. A retrospective cohort study was performed of all women living with HIV who obtained prenatal care from a community-based health center between 2013 and 2019. Women who spoke English or Spanish, remained within the system, and had not participated in group prenatal care previously were included. Women self-selected a prenatal care model: 85 selected group care and 109 elected individual care. Group prenatal care followed a standard Centering Pregnancy® curriculum with the addition of HIV-related topics. The primary outcomes of the study were viral suppression (viral load <20 copies/mL) and postpartum retention in care (attending at least one or two visits with HIV primary care within 12 months postpartum). After adjusting for potential confounding factors, women who participated in group prenatal care were significantly more likely to have at least one HIV primary care visit postpartum {adjusted odds ratio (aOR) = 2.71 [95% confidence interval (CI 1.14-6.46)]; p = 0.024}, and had a trend for achieving viral suppression by the time of delivery [aOR = 2.29 (95% CI 0.94-5.55); p = 0.068]. We have demonstrated that group prenatal care for pregnant women living with HIV is feasible and effective, with positive impacts on retention in care and viral suppression, factors that affect long-term outcomes from patients living with HIV.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Servicios de Salud Comunitaria/organización & administración , Infecciones por VIH/tratamiento farmacológico , Aceptación de la Atención de Salud/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Retención en el Cuidado , Adulto , Niño , Estudios de Cohortes , Centros Comunitarios de Salud , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Humanos , Atención Posnatal , Periodo Posparto , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Mujeres Embarazadas , Atención Prenatal , Estudios Retrospectivos , Respuesta Virológica Sostenida , Texas/epidemiología , Carga Viral
17.
Tex Med ; 117(2): 16-21, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33641118

RESUMEN

The malaise in physician practice long known as burnout - a term doctors increasingly balk at - has been exacerbated by the pandemic, as an extensive survey by the Physicians Foundation recently showed. It's created its own stressors and made existing ones worse.


Asunto(s)
Agotamiento Profesional/epidemiología , /terapia , Agotamiento Profesional/etiología , Humanos , Médicos/psicología , Texas/epidemiología
18.
Tex Med ; 117(2): 22-25, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33641119

RESUMEN

Not long after COVID-19 hit Texas last March, pediatricians at Austin Regional Clinic (ARC) began screening patients for food insecurity. The timing was coincidental but fortunate given the pandemic's economic toll.


Asunto(s)
/epidemiología , Rol del Médico , Humanos , Desnutrición/diagnóstico , Desnutrición/prevención & control , Texas/epidemiología
19.
Tex Med ; 117(2): 36-38, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33641120

RESUMEN

Texas opened two new medical schools in July - the University of Houston College of Medicine in Houston and Sam Houston State University College of Osteopathic Medicine in Conroe. Thanks to COVID-19, both opened under circumstances that would have seemed bizarre just a year ago.


Asunto(s)
/epidemiología , Facultades de Medicina/organización & administración , Educación Médica/métodos , Educación Médica/organización & administración , Humanos , Texas/epidemiología
20.
Tex Med ; 117(2): 45-46, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33641122

RESUMEN

It's no surprise that many physicians were among the more than 1.3 million confirmed COVID-19 cases in Texas last year. Texas Medicine spoke with three Texas physicians who contracted COVID-19 to learn how the disease affected them physically and impacted their outlook as caregivers.


Asunto(s)
/epidemiología , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Médicos , /transmisión , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Obligaciones Morales , Texas/epidemiología
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