Helicobacter pylori infection and the effect on growth in a cohort of children in the US/Mexico border

Helicobacter pylori (H. pylori) is an S-shaped or curved gram-negative bacterium that is mostly found in the human stomach. H. pylori causes gastritis in adults and children, which can lead to gastric ulcers or risk of cancer. Transmission of this bacterial infection remains to be unknown but is mostly acquired during childhood. Little is known about the effect H. pylori has on growth in children. Although some studies have reported that H. pylori is associated with subnormal growth, the association of H. pylori with growth retardation and malnutrition is poorly described. Data from this study comes from The Pasitos Cohort Study which draws its population from three border communities which include Socorro and San Elizario in Texas, as well as Ciudad Juarez, Chihuahua, Mexico. Birth documentation was obtained for 803 infants and 472 entered follow-up. This cohort study allowed us to assess the growth of children from 6 months to the seventh anniversary, and describe the prevalence of underweight, short stature and overweight in the study population. We also tested the hypothesis that children in the Pasitos Cohort Study who were ever infected with H. pylori show an increased risk of growth retardation or malnutrition at 66 months of age. Using the 2000 CDC Growth Reference, we found that the mean BMI of the study population increased as children grew older, while the mean of their height for age decreased slightly. The proportion of children who were classified as of short stature was under 5%, while those considered underweight were less than 10% at selected six-months of age intervals. Using the subset of children who were 66 months of age we found that the risk of underweight was higher among those who ever tested positive for H. pylori infection using the urea breath test; however, due to small numbers of children with 'wasting' this difference was not statistically significant. Moreover, since the six cases of under weight occurred among children of low socio-economic status we could not rule out potential confounding. The risk of developing short stature was not different among those ever infected and those who never tested positive for H. pylori infection. ^

The impact of 1995--1996 health sector reforms in the effectiveness of malaria control program in the state of Orissa, India

Malaria poses a significant public health problem worldwide. The World Health Organization indicates that approximately 40% of the world's population and almost 85% of the population from the South–East Asian region is at risk of contracting malaria. India being the most populous country in the region, contributes the highest number of malaria cases and deaths attributed to malaria. Orissa is the state that has the highest number of malaria cases and deaths attributable to malaria. A secondary data analysis was carried out to evaluate the effectiveness of the World bank-assisted Malaria Action Program in the state of Orissa under the health sector reforms of 1995-96. The secondary analysis utilized the government of India's National Anti Malaria Management Information System's (NAMMIS) surveillance data and the National Family Health Survey (NFHS–I and NFHS–II) datasets to compare the malaria mortality and morbidity in the state between 1992-93 and 1998-99. Results revealed no effect of the intervention and indicated an increase of 2.18 times in malaria mortality between 1992-1999 and an increase of 1.53 times in malaria morbidity between 1992-93 and 1998-99 in the state. The difference in the age-adjusted malaria morbidity in the state between the time periods of 1992-93 and 1998-99 proved to be highly significant (t = 4.29 df=16, p<. 0005) whereas the difference between the increase of age-adjusted malaria morbidity during 1992-93 and 1998-99 between Orissa (with intervention) and Bihar (no intervention) proved to be non significant (t=.0471 df=16, p<.50). Factors such as underutilization of World Bank funds for the malaria control program, inadequate health care infrastructure, structural adjustment problems, poor management, poor financial management, parasite resistance to anti-malarial drugs, inadequate supply of drugs and staff shortages may have contributed to the failure of the program in the state.^

Understanding disparities in emergency department visits for asthma

Asthma is the most common chronic disorder in childhood, affecting an estimated 6.2 million children under 18 years (1). The purpose of this study was to look at individual- and community-level characteristics simultaneously to examine and explain the factors that contribute to the use of emergency department services by children 18 years old or less and to determine if there was an association between air quality and ED visits in the same population, from 2005-2007 in Houston/Harris County. Data were collected from the Houston Safety Net Hospital Emergency Department Use Study and the 2000 US Census. Bivariate and multivariate logistic regression models and mixed effects models were used to analyze data that was collected during the study period.^ There were 704,902 ED visits made by children 18 and younger, who were living in Houston from January 1, 2005 to December 31, 2007. Of those, 19,098 had a primary discharge diagnosis of asthma. Asthma ED visits varied by season, with proportions of ED visits for asthma highest from September-December. African-American children were 2.6 (95% CI, 2.43-2.66) times more likely to have an ED visit for asthma compared to White children. Poverty, single parent headed households, and younger age all a greater likelihood of having gone to the ED for asthma treatment. Compared to Whites living in lightly-monitored pollution areas, African-Americans and Hispanics living in heavily monitored areas were 1.15 (95% CI, 1.04-1.28) times more likely to have an ED visit for asthma.^ Race and poverty seem to account for a large portion of the disparities in ED use found among children. This was true even after accounting for multiple individual- and community-level variables. These results suggest that racial disparities in asthma continue to pose risks for African American children, and they point to the need for additional research into potential explanations and remedies. Programs to reduce inappropriate ED use must be sensitive to an array of complex socioeconomic issues within minority and income populations. ^

Demographic and social factors which influence periodontal disease using the National Health and Nutritional Examination Survey (NHANES)

Periodontal diseases include the various forms of gingivitis and periodontitis. Scientific literature submits 80% of the population suffers from some form of periodontal disease. The comparison of studies measuring periodontal disease is difficult because researchers use various parameters and indexes to define disease severity. The purposes of this paper were to examine the associations of gingival bleeding and 3 or more millimeters periodontal attachment loss, and age, sex, income, race/ethnicity, current tobacco use, dental visits, health insurance, stroke, heart attack, and diabetes using the periodontal examination population from the National Health and Nutritional Examination Survey (NHANES) 1999-2004. ^ When all risk factors were analyzed in the model as a whole sex, race/ethnicity, poverty, and education were statistically significant for bleeding on probing. When all risk factors were analyzed in the model as a whole sex, age, and education were statistically significant for loss of attachment. ^

LONGITUDINAL GROWTH PARAMETERS AND THEIR ECOLOGICAL DETERMINANTS (SEASONALITY)

The growth patterns of weight from birth through the first twelve months of life among rural Taiwanese infants were investigated with the following objectives: (i) compare each of the parameters of the Count model estimated for infants who were nutritionally at risk with those for a reference population from the United States; and (ii) within the Taiwanese infants, account for the variance in the growth patterns in the first and second six months of life on the basis of selected ecological factors.^ The significance between group differences were observed in the patterns of the weight growth in both linear growth and in the timing and the direction of velocity changes. A significant decline in growth velocity was observed among Taiwanese infants at about the fourth month of life. The decline is in keeping with a recent proposal made by J. C. Waterlow regarding the timing of change in growth velocity among nutritionally at risk populations in developing countries. The growth course of a nutritionally at risk infant during the first three months is apparently protected by the nurturance of the mother and innate biological properties of the infant.^ A highly significant portion of the growth variance in the second six months of life was accounted for by exogenous factors and biological factors related to the infant. Conversely, none of the growth variance in the first six months of life was accounted for by predictor variables. The most potent determinant of growth in the second six months of life was seasonality which represents a multiple environmental event.^ The model parameters estimated from the Count model represent different aspect of physical growth; yet the correlation coefficients between parameters b and c are high (r > .80). Clearly, the biological interpretation of the model parameters requires analysis of the whole function in the specific context of a given age period. ^

Genetic Predictors of Clinical Outcomes in Non-Small Cell Lung Cancer Patients

Lung cancer is the leading cause of cancer-related mortality in the US. Emerging evidence has shown that host genetic factors can interact with environmental exposures to influence patient susceptibility to the diseases as well as clinical outcomes, such as survival and recurrence. We aimed to identify genetic prognostic markers for non-small cell lung cancer (NSCLC), a major (85%) subtype of lung cancer, and also in other subgroups. With the fast evolution of genotyping technology, genetic association studies have went through candidate gene approach, to pathway-based approach, to the genome wide association study (GWAS). Even in the era of GWAS, pathway-based approach has its own advantages on studying cancer clinical outcomes: it is cost-effective, requiring a smaller sample size than GWAS easier to identify a validation population and explore gene-gene interactions. In the current study, we adopted pathway-based approach focusing on two critical pathways - miRNA and inflammation pathways. MicroRNAs (miRNA) post-transcriptionally regulate around 30% of human genes. Polymorphisms within miRNA processing pathways and binding sites may influence patients’ prognosis through altered gene regulation. Inflammation plays an important role in cancer initiation and progression, and also has shown to impact patients’ clinical outcomes. We first evaluated 240 single nucleotide polymorphisms (SNPs) in miRNA biogenesis genes and predicted binding sites in NSCLC patients to determine associations with clinical outcomes in early-stage (stage I and II) and late-stage (stage III and IV) lung cancer patients, respectively. First, in 535 early-stage patients, after correcting multiple comparisons, FZD4:rs713065 (hazard ratio [HR]:0.46, 95% confidence interval [CI]:0.32-0.65) showed a significant inverse association with survival in early stage surgery-only patients. SP1:rs17695156 (HR:2.22, 95% CI:1.44-3.41) and DROSHA:rs6886834 (HR:6.38, 95% CI:2.49-16.31) conferred increased risk of progression in the all patients and surgery-only populations, respectively. FAS:rs2234978 was significantly associated with improved survival in all patients (HR:0.59, 95% CI:0.44-0.77) and in the surgery plus chemotherapy populations (HR:0.19, 95% CI:0.07-0.46).. Functional genomics analysis demonstrated that this variant creates a miR-651 binding site resulting in altered miRNA regulation of FAS, providing biological plausibility for the observed association. We then analyzed these associations in 598 late-stage patients. After multiple comparison corrections, no SNPs remained significant in the late stage group, while the top SNP NAT1:rs15561 (HR=1.98, 96%CI=1.32-2.94) conferred a significantly increased risk of death in the chemotherapy subgroup. To test the hypothesis that genetic variants in the inflammation-related pathways may be associated with survival in NSCLC patients, we first conducted a three-stage study. In the discovery phase, we investigated a comprehensive panel of 11,930 inflammation-related SNPs in three independent lung cancer populations. A missense SNP (rs2071554) in HLA-DOB was significantly associated with poor survival in the discovery population (HR: 1.46, 95% CI: 1.02-2.09), internal validation population (HR: 1.51, 95% CI: 1.02-2.25), and external validation (HR: 1.52, 95% CI: 1.01-2.29) population. Rs2900420 in KLRK1 was significantly associated with a reduced risk for death in the discovery (HR: 0.76, 95% CI: 0.60-0.96) and internal validation (HR: 0.77, 95% CI: 0.61-0.99) populations, and the association reached borderline significance in the external validation population (HR: 0.80, 95% CI: 0.63-1.02). We also evaluated these inflammation-related SNPs in NSCLC patients in never smokers. Lung cancer in never smokers has been increasingly recognized as distinct disease from that in ever-smokers. A two-stage study was performed using a discovery population from MD Anderson (411 patients) and a validation population from Mayo Clinic (311 patients). Three SNPs (IL17RA:rs879576, BMP8A:rs698141, and STK:rs290229) that were significantly associated with survival were validated (pCD74:rs1056400 and CD38:rs10805347) were borderline significant (p=0.08) in the Mayo Clinic population. In the combined analysis, IL17RA:rs879576 resulted in a 40% reduction in the risk for death (p=4.1 × 10-5 [p=0.61, heterogeneity test]). We also validated a survival tree created in MD Anderson population in the Mayo Clinic population. In conclusion, our results provided strong evidence that genetic variations in specific pathways that examined (miRNA and inflammation pathways) influenced clinical outcomes in NSCLC patients, and with further functional studies, the novel loci have potential to be translated into clinical use.

Evaluation of CHIP perinatal program outcomes in Harris County, Texas

This study compared initial year trends in prenatal care and birth outcomes of women enrolled in the Texas Children's Health Insurance Program (CHIP) Perinatal program to trends in Medicaid program women. The study utilized claims data from Community Health Choice (CHC), a health plan in Harris County, Texas that provides coverage to both populations. Quarterly data was analyzed and compared for the first two years of the CHIP Perinatal program (2007-2008) to determine if outcome trends for the CHIP program improved over the outcome trends seen with those enrolled in Medicaid. Study findings indicate an increase in the quarterly prenatal care utilization for the CHIP Perinatal population from 2007 to 2008 and the associated birth weights of babies delivered also had marginal improvements during the same timeframe. Enrollees in Medicaid continued to have overall better outcomes than those enrolled within the CHIP Perinatal program. However, the study showed that the rate of improvement in both prenatal care utilization and birth outcomes were greater for the CHIP Perinatal enrollees than those enrolled in Medicaid. ^ The majority of these improvements were significant when comparing each coverage program and from year to year. Lastly, the study showed that there was a correlation between prenatal care utilization and birth outcomes. However, further analysis of the data could not conclusively indicate that access to prenatal care services provided by the CHIP Perinatal program contributed to the increases observed in utilization and birth outcomes for the study's sample population.^

La población mundial : de la explosión a la implosión demográfica

El ritmo de crecimiento de la población mundial es observado en general desde una perspectiva negativa, basada en argumentaciones económicas o ecológicas. El temor a la sobrepoblación, que comenzó a difundirse cuando la humanidad alcanzó los mil millones, con frecuencia fue potenciado hasta la categoría de alarmismo, especialmente en ocasión de la incorporación de mil millones más, y desde entonces se traduce en el propósito de frenar el crecimiento, generalmente con medidas antinatalistas. A principios del siglo XXI, ante el fenómeno de la reducción planetaria de las tasas de crecimiento, se perfila un nuevo alarmismo por infrapoblación, que coexiste sin embargo con un alarmismo por sobrepoblación.

Las prácticas de la enseñanza en la Educación Superior : Reflexiones pedagógico-didácticas sobre los usos de las tecnologías informáticas en las aulas

El presente trabajo da cuenta de una investigación llevada a cabo entre mediados y fines de los años `90 como parte de la acreditación académica del grado de Licenciatura en Ciencias de la Educación. La misma aborda como tema de estudio el campo de la Educación Superior y las Tecnologías Informáticas, particularmente el uso pedagógico-didáctico que se hace de dichas tecnologías a partir de su introducción en las prácticas de enseñanza. Metodológicamente se trabajó en dos etapas con de estilos de indagación diferenciados, pero a la vez imbricados. La primera consistió en recoger la mirada institucional respecto a la introducción de dichas tecnologías. A tales efectos, se seleccionó como población del estudio a miembros responsables de la conducción institucional de algunas de las Unidades Académicas de la Universidad Nacional de La Plata e Institutos Superiores de Formación Docentes -públicos y privados- de la provincia de Bs. As. Mientras que la segunda etapa se configuró a partir de los hallazgos de la anterior dando lugar a la necesidad de profundizar, mediante un estudio de casos, en el análisis de prácticas de enseñanza en las que se produce la inclusión de las tecnologías informáticas. Intentando visualizar en ellas, no sólo, la introducción de un artefacto novedoso sino la presencia de elementos de una cultura de innovación educativa que den cuenta de procesos de reflexión y de cambio en dichas prácticas. Las conclusiones arribadas posibilitaron integrar la dimensión institucional con la dimensión áulica; conocer prácticas de enseñanza que intentan, desde su espacio de trabajo, modificar la estructura de clase tradicional, acercando a los alumnos otras posibilidades de acceso al conocimiento y vislumbrar, en forma incipiente y en función de las posibilidades profesionales y personales de cada profesor, niveles de reflexión de su propia práctica con el propósito de mejorarlas.

Transferable skills following WAIS-II verbal comprehension index

In this document the results and the reflections brought about by the research for the standardization of the verbal comprehension index of Wechsler scale subtests for measuring adult intelligence, WAIS -III for the general population from 16 to 24 years for the city of La Plata , using the collective administration modality are reported In this opportunity, the performance of 229 students from secondary school from 16 to 18 years, both genders, is being analyzed in the information subtest, as well as that of 155 university and non-university tertiary students from 19 to 24 years, both genders in the same subtest The information subtest is of particular interest because of the implication of previous knowledges in the text comprehension and the personal transferable skills. Given the responses, the analysis allow to make some observations a) there are no statistically significant differences between the individual and the collective administration, by gender and b) the average of correct responses for both age groups is the same but the score distribution shows a greater homogeneity in the group from 16 to18 years.

Violencia de género : Descripción y resultados de una investigación sobre mujeres golpeadas

La Cátedra "Fundamentos, Técnicas e Instrumentos de la Exploración Psicológica II" inició en el año 2006 una Investigación titulada: Violencia: Mujer golpeada. Delimitación de estructura psíquica mediante Técnicas Proyectivas. El rastreo bibliográfico nos permitió delimitar dos líneas explicativas que giran alrededor de esta situación, a saber: a) Una correspondiente a la línea psico - socio - económica. b) La otra centrada psicoanalíticamente sobre la estructura y dinámica psíquica de las mujeres que son golpeadas (deslindando las situaciones extremas de la perversión y las que corresponden a las costumbres de tipo cultural). La primera línea no satisface nuestras expectativas, ya que nos dan razones suficientes, pero no necesarias. Se asientan en lo que hemos dado en llamar "Teoría de la escasez" (falta de recursos, de afectos y de red social), pero sabemos que no es necesario que estas "faltas" se encuentren presentes para que una mujer sea golpeada. La segunda línea explicativa en cambio, nos permitió hipotetizar que "algo de la estructura psíquica debía estar en juego." Esto nos llevó a implementar una Batería de Técnicas Proyectivas para investigar estructuras psíquicas, la cual aplicamos a un grupo de casos obtenido de población urbana, de distintas edades, clases sociales y nivel educacional. Obteniendo hasta el momento indicadores que nos hablan de una indefensión yoica. Prevaleciendo las defensas maníacas reveladas como idealización del otro, negación e identificación con el agresor

Las prácticas de la enseñanza en la Educación Superior : Reflexiones pedagógico-didácticas sobre los usos de las tecnologías informáticas en las aulas

El presente trabajo da cuenta de una investigación llevada a cabo entre mediados y fines de los años `90 como parte de la acreditación académica del grado de Licenciatura en Ciencias de la Educación. La misma aborda como tema de estudio el campo de la Educación Superior y las Tecnologías Informáticas, particularmente el uso pedagógico-didáctico que se hace de dichas tecnologías a partir de su introducción en las prácticas de enseñanza. Metodológicamente se trabajó en dos etapas con de estilos de indagación diferenciados, pero a la vez imbricados. La primera consistió en recoger la mirada institucional respecto a la introducción de dichas tecnologías. A tales efectos, se seleccionó como población del estudio a miembros responsables de la conducción institucional de algunas de las Unidades Académicas de la Universidad Nacional de La Plata e Institutos Superiores de Formación Docentes -públicos y privados- de la provincia de Bs. As. Mientras que la segunda etapa se configuró a partir de los hallazgos de la anterior dando lugar a la necesidad de profundizar, mediante un estudio de casos, en el análisis de prácticas de enseñanza en las que se produce la inclusión de las tecnologías informáticas. Intentando visualizar en ellas, no sólo, la introducción de un artefacto novedoso sino la presencia de elementos de una cultura de innovación educativa que den cuenta de procesos de reflexión y de cambio en dichas prácticas. Las conclusiones arribadas posibilitaron integrar la dimensión institucional con la dimensión áulica; conocer prácticas de enseñanza que intentan, desde su espacio de trabajo, modificar la estructura de clase tradicional, acercando a los alumnos otras posibilidades de acceso al conocimiento y vislumbrar, en forma incipiente y en función de las posibilidades profesionales y personales de cada profesor, niveles de reflexión de su propia práctica con el propósito de mejorarlas.

Transferable skills following WAIS-II verbal comprehension index

In this document the results and the reflections brought about by the research for the standardization of the verbal comprehension index of Wechsler scale subtests for measuring adult intelligence, WAIS -III for the general population from 16 to 24 years for the city of La Plata , using the collective administration modality are reported In this opportunity, the performance of 229 students from secondary school from 16 to 18 years, both genders, is being analyzed in the information subtest, as well as that of 155 university and non-university tertiary students from 19 to 24 years, both genders in the same subtest The information subtest is of particular interest because of the implication of previous knowledges in the text comprehension and the personal transferable skills. Given the responses, the analysis allow to make some observations a) there are no statistically significant differences between the individual and the collective administration, by gender and b) the average of correct responses for both age groups is the same but the score distribution shows a greater homogeneity in the group from 16 to18 years.

Violencia de género : Descripción y resultados de una investigación sobre mujeres golpeadas

La Cátedra "Fundamentos, Técnicas e Instrumentos de la Exploración Psicológica II" inició en el año 2006 una Investigación titulada: Violencia: Mujer golpeada. Delimitación de estructura psíquica mediante Técnicas Proyectivas. El rastreo bibliográfico nos permitió delimitar dos líneas explicativas que giran alrededor de esta situación, a saber: a) Una correspondiente a la línea psico - socio - económica. b) La otra centrada psicoanalíticamente sobre la estructura y dinámica psíquica de las mujeres que son golpeadas (deslindando las situaciones extremas de la perversión y las que corresponden a las costumbres de tipo cultural). La primera línea no satisface nuestras expectativas, ya que nos dan razones suficientes, pero no necesarias. Se asientan en lo que hemos dado en llamar "Teoría de la escasez" (falta de recursos, de afectos y de red social), pero sabemos que no es necesario que estas "faltas" se encuentren presentes para que una mujer sea golpeada. La segunda línea explicativa en cambio, nos permitió hipotetizar que "algo de la estructura psíquica debía estar en juego." Esto nos llevó a implementar una Batería de Técnicas Proyectivas para investigar estructuras psíquicas, la cual aplicamos a un grupo de casos obtenido de población urbana, de distintas edades, clases sociales y nivel educacional. Obteniendo hasta el momento indicadores que nos hablan de una indefensión yoica. Prevaleciendo las defensas maníacas reveladas como idealización del otro, negación e identificación con el agresor

Las prácticas de la enseñanza en la Educación Superior : Reflexiones pedagógico-didácticas sobre los usos de las tecnologías informáticas en las aulas

El presente trabajo da cuenta de una investigación llevada a cabo entre mediados y fines de los años `90 como parte de la acreditación académica del grado de Licenciatura en Ciencias de la Educación. La misma aborda como tema de estudio el campo de la Educación Superior y las Tecnologías Informáticas, particularmente el uso pedagógico-didáctico que se hace de dichas tecnologías a partir de su introducción en las prácticas de enseñanza. Metodológicamente se trabajó en dos etapas con de estilos de indagación diferenciados, pero a la vez imbricados. La primera consistió en recoger la mirada institucional respecto a la introducción de dichas tecnologías. A tales efectos, se seleccionó como población del estudio a miembros responsables de la conducción institucional de algunas de las Unidades Académicas de la Universidad Nacional de La Plata e Institutos Superiores de Formación Docentes -públicos y privados- de la provincia de Bs. As. Mientras que la segunda etapa se configuró a partir de los hallazgos de la anterior dando lugar a la necesidad de profundizar, mediante un estudio de casos, en el análisis de prácticas de enseñanza en las que se produce la inclusión de las tecnologías informáticas. Intentando visualizar en ellas, no sólo, la introducción de un artefacto novedoso sino la presencia de elementos de una cultura de innovación educativa que den cuenta de procesos de reflexión y de cambio en dichas prácticas. Las conclusiones arribadas posibilitaron integrar la dimensión institucional con la dimensión áulica; conocer prácticas de enseñanza que intentan, desde su espacio de trabajo, modificar la estructura de clase tradicional, acercando a los alumnos otras posibilidades de acceso al conocimiento y vislumbrar, en forma incipiente y en función de las posibilidades profesionales y personales de cada profesor, niveles de reflexión de su propia práctica con el propósito de mejorarlas.