Validity of the EQ-5D-5L and reference norms for the Spanish population.

BACKGROUND AND OBJECTIVE: The EuroQol 5 dimensions 5 levels (EQ-5D-5L) is the new version of EQ-5D, developed to improve its discriminatory capacity. This study aims to evaluate the construct validity of the Spanish version and provide index and dimension population-based reference norms for the new EQ-5D-5L. METHODS: Data were obtained from the 2011/2012 Spanish National Health Survey, with a representative sample (n = 20,587) of non-institutionalized Spanish adults (≥ 18 years). The EQ-5D-5L index was calculated by using the Spanish value set. Construct validity was evaluated by comparing known groups with estimators obtained through regression models, adjusted by age and gender. Sampling weights were applied to restore the representativeness of the sample and to calculate the norms stratified by gender and age groups. We calculated the percentages and standard errors of dimensions, and the deciles, percentiles 5 and 95, means, and 95% confidence intervals of the health index. RESULTS: All the hypotheses established a priori for known groups were confirmed (P < 0.001). The EQ-5D-5L index indicated worse health in groups with lower education level (from 0.94 to 0.87), higher number of chronic conditions (0.96-0.79), probable psychiatric disorder (0.94 vs 0.80), strong limitations (0.96-0.46), higher number of days of restriction (0.93-0.64) or confinement to bed (0.92-0.49), and hospitalized in the previous 12 months (0.92 vs 0.81). CONCLUSIONS: The EQ-5D-5L is a valid instrument to measure perceived health in the Spanish-speaking population. The representative population-based norms provided here will help improve the interpretation of results obtained with the new EQ-5D-5L.

Klebsiella pneumoniae sequence type 11 from companion animals bearing ArmA methyltransferase, DHA-1 ß-lactamase, and QnrB4.

Seven Klebsiella pneumoniae isolates from dogs and cats in Spain were found to be highly resistant to aminoglycosides, and ArmA methyltransferase was responsible for this phenotype. All isolates were typed by multilocus sequence typing (MLST) as ST11, a human epidemic clone reported worldwide and associated with, among others, OXA-48 and NDM carbapenemases. In the seven strains, armA was borne by an IncR plasmid, pB1025, of 50 kb. The isolates were found to coproduce DHA-1 and SHV-11 ß-lactamases, as well as the QnrB4 resistance determinant. This first report of the ArmA methyltransferase in pets illustrates their importance as a reservoir for human multidrug-resistant K. pneumoniae.

Study on the Attitudes and Knowledge of Teachers and Future Teachers about Immediate Health Care Measures at School.

The level and need for immediate health care measures training for teachers are of growing concern for two main reasons: on the one hand, these contents are part of the school curriculum and, on the other hand, teachers are the first adults to intervene in case of school injury. However, in Spain, first aid (FA) does not appear as obligatory content in the university training of teachers. The aim of the present study was to design and validate a questionnaire on the attitude of pre-school and primary school teachers towards first aid knowledge adapted to the school context and to analyze its psychometric properties. First of all, the psychometric values of the questionnaire were tested: through its validation and reliability. Subsequently, a correlation study was carried out as well as a logistic regression in order to know the knowledge and attitudes of teachers and future teachers about the importance of the Immediate Attention Measures at school. The sample consisted of 392 participants: active teachers (71%) and future teachers (29%, the latter being final year students) of the infant and primary stages from the northern, central and southern areas of Spain. The results show adequate psychometric values, establishing three factors: attitude towards general knowledge in FA and learning methodology; attitude towards wounds and CPR algorithm (most frequent and/or serious events); self-perception of knowledge or skill in FA. Pearson's correlation test identified significant values (p < 0.01) and positive association between Factors 1 and 2 (r = 0.422) and between 1 and 3 (0.244). The conclusions of the results of the validation process of the questionnaire on the attitude of teachers and future teachers to knowledge for immediate health care measures training are valid and reliable to an acceptable degree. Regression study demonstrates the importance of including first aid training in teachers' degrees.

Gender and Socioeconomic Status as Factors of Individual Differences in Pre-University Students' Decision-Making for Careers, with a Focus on Family Influence and Psychosocial Factors.

The present study analyses the influence of family, specifically parents, on the career decisions of their children, and how gender and socioeconomic status influence this choice. Research was carried out using data obtained from a questionnaire administered to a representative sample of students who took the university entrance examination (PEvAU, its Spanish acronym) in Spanish North Africa. A quantitative research design was adopted in which multivariate analysis (MANOVA) was applied anda decision tree, which was also used for graphical and analytical analysis. The main results indicated a significant influence of parents on their children's choices, this being the best predictor regarding the decision to take the said examination. It was also verified that their choice of Spanish Baccalaureate programme was significantly associated with their selected career path, and gender and socioeconomic status had a significant impact on that decision. These results lead to the need for further research on guidance from secondary education onwards. It would be interesting to analyse factors neglected thus far, such as those related to the cultural environment of students.

Quality in Higher Education and Satisfaction among Professors and Students.

The aim of this study was to analyze the significant differences in satisfaction with educational quality in higher education in Italy (Naples) among students and professors. The sample consisted of 501 higher education students and 121 professors, resulting in a total sample size of 622 subjects. Once the quality parameters of the instrument were determined, reliability was confirmed, and data collection was initiated. In order to analyze the results, a test of independent means (Student's t-test) was performed, interrelating the variables of educational quality, concerning both management and satisfaction with higher education. Based on the results, we concluded that there are significant differences between the group of students and the group of professors, highlighting a higher level of satisfaction with quality reported by students regarding the coordination of teachers and staff in the educational process; therefore, the inclusion of students in the direct management of the center should be more active and an indicator to be taken into account in self-evaluation. Despite the limitations in the sample at the regional level, it offers many possibilities for future research.

Promoting Emotional and Social Well-Being and a Sense of Belonging in Adolescents through Participation in Volunteering.

The aim of this study was to analyze the differences within education-related degrees with respect to participation in volunteering. Volunteering motivation promotes and encourages emotional and social well-being and a sense of belonging in university students. This study was based on a total sample of 985 students undertaking Degrees in Early Childhood Education, Primary Education, and Social Education who attended higher education institutions in Northern Africa (Spain) and Eastern Spain. Once the quality parameters of the instrument were determined, the reliability was confirmed, and data collection was initiated. In order to analyze the results, a multilevel study (ANOVA) was conducted by interacting the variables for degrees with three levels (PE = Primary Education; EC = Early Childhood Education; SE = Social Education) and the variable "volunteering is my motivation to feel better", with five levels (strongly disagree, disagree, unsure, agree, and strongly agree). From the data obtained, it was concluded that there were significant differences between the different degree paths, the assessment covering sociodemographic variables and areas of interest showing that volunteering benefits university students both socially and in their decision-making processes.

Evolutionary history and molecular epidemiology of rabbit haemorrhagic disease virus in the Iberian Peninsula and Western Europe.

BACKGROUND: Rabbit haemorrhagic disease virus (RHDV) is a highly virulent calicivirus, first described in domestic rabbits in China in 1984. RHDV appears to be a mutant form of a benign virus that existed in Europe long before the first outbreak. In the Iberian Peninsula, the first epidemic in 1988 severely reduced the populations of autochthonous European wild rabbit. To examine the evolutionary history of RHDV in the Iberian Peninsula, we collected virus samples from wild rabbits and sequenced a fragment of the capsid protein gene VP60. These data together with available sequences from other Western European countries, were analyzed following Bayesian Markov chain Monte Carlo methods to infer their phylogenetic relationships, evolutionary rates and demographic history. RESULTS: Evolutionary relationships of RHDV revealed three main lineages with significant phylogeographic structure. All lineages seem to have emerged at a common period of time, between ~1875 and ~1976. The Iberian Peninsula showed evidences of genetic isolation, probably due to geographic barriers to gene flow, and was also the region with the youngest MRCA.Overall, demographic analyses showed an initial increase and stabilization of the relative genetic diversity of RHDV, and a subsequent reduction in genetic diversity after the first epidemic breakout in 1984, which is compatible with a decline in effective population size. CONCLUSIONS: Results were consistent with the hypothesis that the current Iberian RHDV arose from a single infection between 1869 and 1955 (95% HPD), and rendered a temporal pattern of appearance and extinction of lineages. We propose that the rising positive selection pressure observed throughout the history of RHDV is likely mediated by the host immune system as a consequence of the genetic changes that rendered the virus virulent. Consequently, this relationship is suggested to condition RHDV demographic history.

Molecular characterisation and recent evolution of myxoma virus in Spain.

Myxoma virus and the European rabbit are one of the best-studied examples of coevolution of pathogen virulence and host resistance. Since the introduction of the virus in Spain in 1953, a decrease in its virulence has been observed; however, most strains are still considered highly virulent. To determine whether this attenuation is due to molecular differences, and to characterise the field strains in Spain and the genetic changes that have occurred since the introduction of the virus, we analysed 7,741 bp in 97 virus samples from 12 localities. We found an extremely low genetic variability and an absence of a geographic structure. We defined 35 haplotypes, none of which were identical to the original Lausanne strain. Three genetic groups were determined and were found to occur at different frequencies in different locations. Overall, virus evolution deviated from neutrality and did not conform to a strict molecular clock, probably due to the existence of a strong selective pressure that acts differently across the viral genome.

Bioaccumulation of polychlorinated dibenzodioxins and dibenzofurans in catfish and crabs along an estuarine salinity and contamination gradient.

Elevated but variable levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDD/Fs) were observed in hardhead sea catfish (HH) and blue crabs (BCs), as well as in water and sediment, of the Houston Ship Channel system, Texas, USA. It is hypothesized that the variation was caused by the spatial variability of PCDD/F contamination, together with the natural mobility of organisms in satisfying prey, temperature, salinity, and reproductive requirements. Structural equation modeling was applied to explore the congener-specific relationships between PCDD/F levels in HH and BC tissues and independent predictors such as PCDD/F contamination levels, environmental factors such as salinity and temperature, temporal-spatial factors such as site depth and season, and biological factors such as length, weight, and lipid content. Contamination levels in both sediment and water were statistically significant predictors of the levels of less chlorinated congeners in both HH and BCs, with the standardized regression weight for sediment concentration roughly twice that for the water concentration. This implies that sediments are the dominant route for PCDDIF exposure and remediation efforts should focus on legacy sediment ontamination. Tissue lipid content was a significant predictor of tissue concentrations in HH but only to a lesser extent in BCs, perhaps due to their low lipid content. Site depth and seasonal factors also were significant predictors of tissue concentrations. For the highly chlorinated congeners, only a small fraction of the variance in tissue concentrations was explained by the independent predictors, possibly indicating that uptake and elimination kinetics, biotransformation processes, or both may be more important factors controlling the bioaccumulation of those congeners.

Words-Deeds Gap for the Purchase of Fairtrade Products: A Systematic Literature Review.

Rationale: Nowadays ethical consumerism is part of the agenda of consumers, businesses, and governments for its promise of a brighter future through the consumption of goods with added social or environmental value. Consumption of fair trade goods has been enjoying huge growth in the last few years as people are becoming more conscious of their consumption practices. Objective: In this piece of research we identify existing literature on the words-deeds gap for the purchase of fairly traded products. Moreover, we present and analyze the moderators to the ethical purchasing gap. Method: A collection of research articles was compiled using a key-word search in 3 databases: Scopus, Springerlink, and Sciencedirect. The research was carried out using various groups of keywords and completed using the following three criteria: articles published in English, between 2010 and 2018, in refereed journals. Further to the systematic literature review, all pertinent articles were imported into Atlas.ti for further thematic analysis. Results: Two thousand and seventy eight articles were identified from which 32 met the inclusion criteria. The content analysis resulted in the following themes: Values, Theory of Planned Behavior and Theory of Reasoned Action, Willingness-to-pay, Labels and Certification, Religion, Guilt, Dual Attitudes, Demographics. Conclusion: Despite "moral" products tasting better and self-claims to this direction, there is still a gap between claimed and actual consumption. Research has mostly concentrated on different perspectives, such as willingness to pay, items from the theory of planned behavior or theory of reasoned action. Given the recent developments in the theory of dual attitudes and further to our research this area is currently underrepresented in FT research and could provide useful insights that may increase consumption of FT products.

Sequencing and phylogenomic analysis of whole mitochondrial genomes of animals.

Mitochondrial genomes (mtDNA) of animals are circular molecules of relatively small size, compactly organized, and generally encoding genes for 2 rRNAs, 22 tRNAs, and 13 proteins that are required for mitochondrial function. Methods of mtDNA isolation take advantage of its physical localization apart from the nuclear genome (centrifugation at low speed efficiently separates mitochondria from nuclei) and of its structure (alkaline lysis differentially precipitates linear nuclear DNA, but not circular mtDNA). Furthermore, the recent development of robust long-PCR techniques has boosted high-throughput determination of complete sequences of animal mtDNAs. The exponentially growing number of complete animal mitochondrial genomes deposited in GenBank allows a phylogenomic approach to disentangle phylogenetic relationships among main animal phyla, and provides extensive new data to gain insights on the molecular mechanisms underlying genome evolution.

Concentrations of polychlorinated biphenyls (PCBs) in water, sediment, and aquatic biota in the Houston Ship Channel, Texas.

Polychlorinated biphenyls (PCBs) were quantified in water, sediment, and catfish and crab tissue collected from the Houston Ship Channel (HSC) in Texas. The total concentrations of the 209 PCB congeners ranged from 0.49 to 12.49 ng l(-1), 4.18 to 4601 ng g(-1) dry wt, 4.13 to 1596 ng g(-1) wet wt, and 3.44 to 169 ng g(-1) wet wt, in water, sediment, catfish and crab tissue, respectively. All media showed maximum concentrations greater than studies in other regions with the highest concentrations occurring in the most industrialized segments of the channel. Inter-media correlations suggested that sediment is a source to water. Galveston Bay sediment concentrations compared to a previous study showed a declining trend though the rate of the decline may be slowing. Detailed homolog profiles revealed that the industrialized part of the channel may be receiving PCB-laden sediment from its tributaries. An unusually high fraction of the deca-chlorinated congener (PCB-209) was found in all media. Seen in only a few other studies and in previous air concentrations in the channel, this may point to unusual Aroclor mixtures used in the history of the HSC or to contemporary sources from local industry. A comparison of PCB concentrations obtained using Aroclor, representative congener, and all congener methods, indicated that Aroclors are not an appropriate surrogate for total PCBs and that the NOAA NST method is more representative than the NOAA EPA method.

Educating in antimicrobial resistance awareness: adaptation of the Small World Initiative program to service-learning.

The Small World Initiative (SWI) and Tiny Earth are a consolidated and successful education programs rooted in the USA that tackle the antibiotic crisis by a crowdsourcing strategy. Based on active learning, it challenges young students to discover novel bioactive-producing microorganisms from environmental soil samples. Besides its pedagogical efficiency to impart microbiology content in academic curricula, SWI promotes vocations in research and development in Experimental Sciences and, at the same time, disseminates the antibiotic awareness guidelines of the World Health Organization. We have adapted the SWI program to the Spanish academic environment by a pioneering hierarchic strategy based on service-learning that involves two education levels (higher education and high school) with different degrees of responsibility. Throughout the academic year, 23 SWI teams, each consisting of 3-7 undergraduate students led by one faculty member, coordinated off-campus programs in 22 local high schools, involving 597 high school students as researchers. Post-survey-based evaluation of the program reveals a satisfactory achievement of goals: acquiring scientific abilities and general or personal competences by university students, as well as promoting academic decisions to inspire vocations for science- and technology-oriented degrees in younger students, and successfully communicating scientific culture in antimicrobial resistance to a young stratum of society.

More free syringes, fewer drug injectors in the case of Spain.

International policy on the prevention of HIV and other health problems among drug users should be guided by scientific evidence. However, it has frequently been argued that Needle Exchange Programs (NEPs) have negative effects such as facilitation of injection of illicit drugs, without providing evidence to support this hypothesis. Since the early 1980s Spain has experienced a severe HIV epidemic among drug injectors. A delayed but comprehensive implementation of harm reduction programs has taken place since the early 1990s. This paper assesses trends between 1991 and 2004, both in the number of sterile syringes exchanged or delivered by NEPs or other programs to improve injectors' access to sterile injection material, and in the number of injectors admitted to first treatment for heroin or cocaine dependence, as a proxy for trends in the number of new drug injectors in Spain. The results show increased access to sterile syringes and a sharp decrease in the number of new drug injectors, suggesting that NEPs have not promoted drug injection. A positive overall transition from injecting to smoking was also observed in the most frequent route of heroin or cocaine administration.

A novel mutation in pmrB mediates colistin resistance during therapy of Acinetobacter baumannii.

Acinetobacter baumannii is a highly versatile nosocomial pathogen. Multidrug resistance among A. baumannii isolates led to the use of colistin, subsequently giving rise to colistin-resistant strains. In this study, the genetic and phenotypic profiles of two colistin-resistant A. baumannii isolates were investigated. Two A. baumannii isolates were obtained from Patient 1 (C071 and C440) and three isolates were obtained from Patient 2 (C080, C314 and C428). Susceptibility profiles were determined by VITEK®2 and Etest. Clonality was determined by RAPD analysis and trilocus multiplex PCR. The pmrCAB operon was sequenced and common carbapenemase genes were screened for by PCR. Doubling times, haemolysis, surface motility, biofilm formation, siderophore production and proteolytic activity were phenotypically determined. Finally, whole-genome sequencing was performed for all five isolates. Isolates C440 and C428 were resistant to colistin and were clonally identical to their sensitive counterparts. The cause of colistin resistance was traced to the previously described P233S mutation in pmrB of C440 and to a novel ΔI19 mutation in pmrB of C428. blaOXA-58-like and blaGES-5 from the strains of Patients 1 and 2, respectively, were also detected. C440 had attenuated proteolytic activity and was positive for siderophore production compared with C071. No difference in in vitro virulence was detected between isolates C080, C314 and C428. In conclusion, one common and one novel mutation were encountered in pmrB from two distinct colistin-resistant A. baumannii isolates. These mutations caused colistin resistance during therapy in two distinct clones, and only one of them had altered in vitro virulence.

Clonality, virulence determinants, and profiles of resistance of clinical Acinetobacter baumannii isolates obtained from a Spanish hospital.

INTRODUCTION: Acinetobacter baumannii is a nosocomial pathogen that is showing increasing rates of carbapenem resistance. Multi-Drug Resistant (MDR) International Clones (ICs), associated with certain oxacillinases, are being reported globally. This organism also harbors numerous virulence determinants. In this study, we aim at characterizing A. baumannii isolated from a Spanish hospital in terms of antimicrobial susceptibility, clonality, carbapenemase genes harbored, and virulence determinants expressed. MATERIALS AND METHODS: Fifty nine clinical bloodstream isolates were obtained from 2009 until 2013. Antimicrobial Susceptibility Testing was performed according to the CLSI guidelines. PFGE and tri-locus PCR typing were then performed in order to determine local and international clonality. PCRs for the detection of common carbapenemases were also performed. Production of hemolysis, biofilms, siderophores, surface motility, and proteolysis were determined phenotypically. Doubling times for selected strains were also calculated. Finally, statistical analysis for detecting associations between these factors was conducted. RESULTS AND DISCUSSION: Carbapenem non-susceptibility was 84.75%, suggesting the immediate need for intervention. PFGE showed the distribution of the majority of the isolates among 7 clusters. Although all three ICs were detected, IC II was predominant at 71.19%. blaOXA-24-like was the most prevalent carbapenemase (62.71%), followed by blaOXA-58-like (13.56%), and blaOXA-23-like (11.86%). Strains pertaining to IC II, and those harboring blaOXA-24-like, were positively associated with α-hemolysis, production of strong biofilms, and siderophore production. Harboring blaOXA-23-like and blaOXA-58-like was associated with attenuated virulence. These associations suggest that an interplay exists between these factors that could be locally exploited. CONCLUSIONS: An alarmingly high rate of carbapenem non-susceptibility has been detected in this study. There was a predominance of IC II and blaOXA-24-like, and those factors were associated with heightened expression of virulence determinants. This association could be exploited for modifying treatment regimens and for improving on infection control protocols in this hospital.

Consumer-Brand Relationships under the Marketing 3.0 Paradigm: A Literature Review.

Consumer-brand relationships encompass several dimensions, most of which have attracted growing research attention during the last years. Building these relationships is especially important in the marketing 3.0 era, where it is suggested that customers will choose those brands that satisfy their deepest needs. With these ideas in mind, this article provides a review of two key concepts implied in such relationships: brand love and customer engagement. Although both conceptions focus on different stages of consumer-brand relationships, they actually cover different perspectives on the same process. Moreover, they come from diverse conceptual paradigms: whilst brand love comes from the psychology discipline, engagement derives from diverse areas of the marketing field (e.g., the service-dominant logic perspective). However, their further empirical developments have taken place in marketing. Besides, both terms appear to be applied to different empirical perspectives: brand love is usually linked to the Fast Moving Consumer Goods industry and customer engagement to services.

Distribution of polychlorinated dibenzo-p-dioxins and dibenzofurans in suspended sediments, dissolved phase and bottom sediment in the Houston Ship Channel.

Spatial distributions of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) in the water column and bottom sediments of the Houston Ship Channel in Texas were measured three times over a 1-year period. Total TEQ concentrations in water ranged from 0.01 to 0.25 pg/l for the dissolved phase and from 0.09 to 2.91 pg/l for the suspended phase, while TEQ concentrations in bottom sediments varied from 0.9 to 139.8 ng/kg dry wt. The dissolved concentrations were lower than their respective suspended concentrations, with average dissolved/suspended ratios between 0.11 and 0.59 for individual congeners. More than 89% of the total concentration of 2378-substituted PCDD/PCDFs was attributable to OCDD but 2378-TCDD was the major contributor to total TEQ for the three sampled media. Average logs of organic carbon-normalized suspended sediment-dissolved partitioning coefficients (logK(oc)(obs)) varied between 4.92 and 8.59 l/kg-oc; while in the bottom sediment-dissolved interface, logK(oc)(obs) values ranged from 5.48 to 8.48 l/kg-oc. Observed logK(oc)values varied within a factor of 0.64-1.26 from equilibrium logK(oc) values, suggesting fluxes of PCDD/PCDFs across the interfaces. It was found that in the HSC, on average, the tendency of a compound to move from the particulate phase to the dissolved phase decreases with increasing K(ow).

Depositional flux of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans in an urban setting.

Dry and wet deposition fluxes of the PCDD/F substituted congeners were measured at two different sites (Clinton Drive and Lang Road) in Houston, TX between December 2003 and April 2004. Average total dry deposition fluxes of 351 and 125pgm(-2)d(-1) were found at Clinton Drive and Lang Road, respectively. A wet deposition flux of 2.873pgm(-2)d(-1) was measured at the Clinton Drive site. The results indicated that the dry deposition process exhibited spatial variability. In addition, the results also demonstrated that precipitation, although intermittent, is the most important mechanism for the removal of dioxins from atmosphere in the area of study. Combining the contributions of the dry and wet deposition processes at Clinton Drive resulted in a total bulk deposition flux of 527pg m(-2)d(-1). The total dry and wet deposition fluxes were dominated by OCDD followed by 1,2,3,4,6,7,8-HpCDD at both sites. Overall average dry deposition velocities of 0.35 and 0.15cms(-1) were calculated at Clinton Drive and Lang Road sites, respectively. While these velocities were similar to velocities observed in other geographical areas, the contribution of OCDD to the total deposition flux in Houston was significantly higher, probably reflecting the unique nature and character of Houston dioxin sources. The results also showed that lower chlorinated congeners, primarily present in the gas phase, are more likely to be removed from the atmosphere by precipitation. Relationships between the detected congeners in the dry deposition samples and other routinely measured air pollutants/meteorological parameters were found. The results showed that in general, the dry deposition of these congeners was consistently negatively correlated with SO(2) and NO(x) concentrations in the air and positively correlated with relative humidity. However, more research is needed to ascertain those correlations.

Status and trends of fecal indicator bacteria in two urban watersheds.

This paper examines bacterial levels and their causes in two Houston bayous (Texas). Buffalo and Whiteoak bayous are two of the most contaminated water bodies in Texas for indicator bacteria, based on the frequency and magnitude of contact recreation water quality exceedances. Examination of historical data indicates frequent exceedances, although some improvement has been made since the 1970s. Statistical analyses showed some correlation between in-stream fecal coliform concentrations and rainfall and with land use. Differences in fecal coliform concentrations were found between high- and low-flow conditions in Whiteoak Bayou, while reservoir releases confounded this relationship in Buffalo Bayou. Wastewater treatment plant effluent was found to make up two-thirds to three-fourths of the median flow in both bayous. Effluent sampling was conducted at 72 of the approximately 140 wastewater treatment plants (WWTPs) in the watersheds, providing evidence that WWTP effluent could act to maintain low-flow concentrations of fecal coliform in the bayous.