An analysis of Texas's school based HPV vaccine mandate: A public health risk communication failure: HPVETO!

Genital human papillomavirus (HPV) is of public health concern because persistent infection with certain HPV types can cause cervical cancer. In response to a nationwide push for cervical cancer legislation, Texas Governor Rick Perry bypassed the traditional legislative process and issued an executive order mandating compulsory HPV vaccinations for all female public school students prior to their entrance in the sixth grade. By bypassing the legislative process Governor Perry did not effectively mitigate the risk perception issues that arose around the need for and usefulness of the vaccine mandate. This policy paper uses a social policy paradigm to identify perception as the key intervening factor on how the public responds to risk information. To demonstrate how the HPV mandate failed, it analyzes four factors, economics, politics, knowledge and culture, that shape perception and influence the public's response. By understanding the factors that influence the public's perception, public health practitioners and policy makers can more effectively create preventive health policy at the state level. ^

An investigation into the relationship between screen time, consumption of advertised foods, and physical activity among Texas 4th grade elementary school children

Background. The high prevalence of obesity among children has spurred creation of a list of possible causative factors, including the advertising of foods of minimal nutritional value, a decrease in physical activity, and increased media use. Few studies show prevalence rates of these factors among large cohorts of children. ^ Methods. Using data from the 2004-2005 School Physical Activity and Nutrition project (SPAN), a secondary analysis of 7907 4th-grade children (mean age 9.74 years) was conducted. In addition, a comic-book–based intervention that addressed advertised food consumption, physical activity, and media use was developed and evaluated using a pre-post test design among 4th-grade children in an urban school district. ^ Results. Among a cohort of 4th-grade children across the state of Texas, children who had more than 2 hours of video game or computer time the previous day were more than twice as likely to drink soda and eat candy or pastries. In addition, children who watched more than 2 hours of TV the previous day were more than three times as likely to consume chips, punch, soda, candy, frozen desserts, or pastries (AOR 3.41, 95% CI: 1.58, 7.37). A comic-book based intervention held great promise and acceptance among 4th-grade children. Outcome evaluation showed that while results moved in a positive direction, they were not statistically significant. ^ Conclusion. Statistically significant associations were found between screen time and eating various types of advertised food. The comic book intervention was widely accepted by the children exposed to it, and pre-post surveys indicated they moved constructs in a positive direction. Further research is needed to look at more specific ways in which children are exposed to TV, and the relationship of the TV viewing time with their consumption of advertised foods. In addition, researchers should look at comic book interventions more closely and attempt to utilize them in more in studies with a longer follow-up time. ^

School screening for tuberculosis in high risk areas of Texas

Screening for latent tuberculosis infection (LTBI) is an integral component of an effective tuberculosis control strategy, but one that is often relegated to the lowest priority. In a state with higher than national average rates of tuberculosis, due consideration should be given to LTBI screening. Recent large scale contact investigations in the middle school of Del Rio, Texas, raised questions about the status of school screening for LTBI. An evidence based approach was used to evaluate school screening in high risk areas of Texas. A review of the literature revealed that the current recommendations for LTBI screening in children is based on administration of a risk factor questionnaire that should be based on the four main risk factors for LTBI in children that have been identified. Six representative areas in Texas were identified for evaluation of the occurrence of contact investigations in schools for the period of 2006 to 2009 and any use of school screening programs. Of the five reporting areas that responded, only one utilized a school screening program; this reporting area had the lowest percentage of contact investigations occurring in schools. Contact investigations were most common in middle schools and least common in elementary schools. In metropolitan areas, colleges represented up to 42.9% of contact investigations. The number of contact investigations has increased from 2006 to 2008. This report represents a small sample, and further research into the frequency, distribution and risk for contact investigations in schools and the efficacy of screening programs should be done. ^

Is maternal separation anxiety associated with school readiness?

Background. Increasing rates of maternal employment highlight the need for non-maternal child care for infants at an earlier age. Several studies have shown that employment induced maternal depression or psychological distress is associated with the child's socio-emotional and cognitive development. However, separation anxiety, a common phenomenon observed among employed mothers during early years, has seldom been studied. Therefore, the purpose of this study was to evaluate the role of maternal separation anxiety in the child's cognitive development.^ Methods. Data were obtained from Phase I (birth to 36 months) of the National Institute of Child Health and Human Development, Study of Early Child Care and Youth Development (NICHD SECCYD). Bivariate and multivariate analyses were performed to determine the association between separation anxiety groups and child outcomes. Multivariate analysis was also used to examine the mediating and/or moderating effect of sensitivity and moderating effect of difficult temperament.^ Results. Separation anxiety showed a negative association with the Bracken, attachment security, maternal sensitivity and psychological state. Children whose mothers never reported high levels of separation anxiety showed higher levels of school readiness and attachment security compared to those whose mothers experienced high levels of separation anxiety at least once. There was a significant interaction between separation anxiety and maternal sensitivity for the Bracken and attachment security indicating the moderating effect of sensitivity. Maternal sensitivity was also found to partially mediate the association between high levels of separation anxiety and school readiness or attachment security. However, the interaction between difficult temperament and separation anxiety was not significant for any of the child outcomes. ^ Conclusions. High levels of separation anxiety have a negative impact on school readiness, attachment security, maternal sensitivity and psychological state. In addition, mothers who experience high levels of separation anxiety but are sensitive during the mother-child interaction have children with high school readiness and attachment security compared to those who are less sensitive.^ Keywords. Maternal separation anxiety, School readiness. ^

THE EFFECT OF IRON SUPPLEMENT ON THE GROWTH OF RURAL INDONESIAN SCHOOL CHILDREN

The effect of oral iron supplementation on blood iron levels and physical growth in 119 Indonesian rural school children was assessed in the double-blind study. The children were classified into anemic and normal groups according to their initial hemoglobin and transferrin saturation levels and were randomly assigned to either iron or placebo treatment for twelve weeks. Biochemical, anthropometric and morbidity data were collected prior to and after the treatment period. Before treatment, anemic subjects were smaller and had higher morbidity than normal subjects. Treatment with 10 mg ferrous sulfate/kg/day for twelve weeks resulted in a significant improvement in blood iron biochemical status of the anemic subjects and in their growth velocity and morbidity. ^

U.S. school based sealant programs: Review of their most common characteristics

In the United States, dental caries is the most common chronic illness in children, occurring five to eight times as frequently as asthma. 11 Dental caries is an unmet health need, disproportionately affecting minority groups and individuals with low socio-economic status.15,34,36 School-Based Sealant Programs were developed to target children at risk, to provide dental services in a closer geographic area, to offer low cost preventive dental services, and to educate families about oral health and prevention.1 There is scientific, evidence based literature that shows the effectiveness of dental sealants preventing dental decay. 13^ Currently, there is no central source for cataloging School-Based Sealant Programs (SBSPs). Information is scattered around publications and documents. For instance, the National Health and Nutrition Examination Survey (NHANES) does not have information about all the existing SBSPs. ^ This literature review determined which are the most common characteristics of SBSPs in the U.S. and determined the extent to which these programs provide sealants to children of low socio-economic status. The method utilized was an electronic database search. Pubmed and EBESCO host databases were searched with Mesh terms like “dental school sealant programs”, “community dentistry”, “school based sealant programs” and “oral preventive programs”. Results were organized in terms of location, population served, providers, funding source and data shared. ^ The searches produced 77 studies, from which 40 were included in this work. Only 18 U.S. states were represented in the results; however these findings are very consistent with the Best Practice Approach – School Based Sealant Programs3. Most of the SBSPs provide their services to children from low income families, and utilized the lower labor cost providers permitted by their state regulations. The author intends that this thesis work will become an aide in the development of future programs, and as evidence for the sustainability of these programs.^

Assessing how middle school students' nutrient intake varies based on the availability of a la carte offerings at lunch

Purpose: School districts in the U.S. regularly offer foods that compete with the USDA reimbursable meal, known as `a la carte' foods. These foods must adhere to state nutritional regulations; however, the implementation of these regulations often differs across districts. The purpose of this study is to compare two methods of offering a la carte foods on student's lunch intake: 1) an extensive a la carte program in which schools have a separate area for a la carte food sales, that includes non-reimbursable entrees; and 2) a moderate a la carte program, which offers the sale of a la carte foods on the same serving line with reimbursable meals. ^ Methods: Direct observation was used to assess children's lunch consumption in six schools, across two districts in Central Texas (n=373 observations). Schools were matched on socioeconomic status. Data collectors were randomly assigned to students, and recorded foods obtained, foods consumed, source of food, gender, grade, and ethnicity. Observations were entered into a nutrient database program, FIAS Millennium Edition, to obtain nutritional information. Differences in energy and nutrient intake across lunch sources and districts were assessed using ANOVA and independent t-tests. A linear regression model was applied to control for potential confounders. ^ Results: Students at schools with extensive a la carte programs consumed significantly more calories, carbohydrates, total fat, saturated fat, calcium, and sodium compared to students in schools with moderate a la carte offerings (p<.05). Students in the extensive a la carte program consumed approximately 94 calories more than students in the moderate a la carte program. There was no significant difference in the energy consumption in students who consumed any amount of a la carte compared to students who consumed none. In both districts, students who consumed a la carte offerings were more likely to consume sugar-sweetened beverages, sweets, chips, and pizza compared to students who consumed no a la carte foods. ^ Conclusion: The amount, type and method of offering a la carte foods can significantly affect student dietary intake. This pilot study indicates that when a la carte foods are more available, students consume more calories. Findings underscore the need for further investigation on how availability of a la carte foods affects children's diets. Guidelines for school a la carte offerings should be maximized to encourage the consumption of healthful foods and appropriate energy intake.^

Student consumption of a la carte foods during school lunch meals

The purpose of this study was to evaluate students' lunch consumption compared to NSLP guidelines, the contribution of competitive foods to calorie intake at lunch, and the differences in nutrient and food group intake between the a la carte food consumers and non- a la carte food consumers.^ In Fall 2011, 1170 elementary and 440 intermediate students were observed anonymously during school lunch. The foods eaten, their source, grade level, and gender were recorded. All a la carte offerings met the Texas School Nutrition Policy.^ Differences in nutrient and food group intake by grade level and between students who consumed a la carte and those who did not were assessed using ANCOVA. A chi-squared analysis was conducted to evaluate differences in a la carte food consumption by grade level, gender, and the school's low income status.^ Average lunch intakes for elementary students were 457 (SD 164) calories for elementary students and 541 calories (SD 188) for intermediate students (p<0.001). 760 students (47%) consumed 937 a la carte foods, with the most often consumed items being chips (32%), ice cream (22%) and snack items (18%). Mean a la carte food intakes were 60 and 98 calories for elementary and intermediate schools respectively (p<0.001). Significantly more (p<0.000) intermediate students (34.3%) consumed a la carte items compared to elementary students (27.5%).^ Students who consumed a la carte foods had significantly higher intakes of calories (p<0.000), fat (p<0.000), sodium (p<0.002), fiber (p<0.000), added sugar (p<0.000), total grains (p<0.000), dessert foods (p<0.000), and snack chips (p<0.000) and lower intakes of vitamin A (p<0.001), iron (p<0.000), fruit (p<0.022), vegetables (p<0.031), milk (p<0.000), and juice (p<0.000) compared to students who did not eat a la carte foods.^ Although previous studies have found that reducing availability of unhealthy items at school decreased student consumption of these items, the results of this study indicate that even the strict guidelines set forth by the state of Texas are not sufficient to prevent increased caloric intake and poor nutrient intake. Strategies to improve student selection and consumption at school lunch when a la carte foods are available are warranted.^

Altered cholesterol metabolism in a hypercholesterolemia -resistant rabbit colony

A colony of rabbits has been developed at the University of Texas Medical School at Houston that is resistant to dietary-induced hypercholesterolemia. The liver of resistant rabbits had higher levels of ($\sp{125}$I) $\beta$-VLDL binding and 3-hydroxy-3-methylglutaryl (HMGCoA) reductase activity, but lower acyl coenzyme A:cholesterol acyltransferase (ACAT) activity than normal rabbits. Direct quantitation of intracellular cholesterol content of the liver revealed that the resistant rabbits had $<$10% of the intracellular free cholesterol present in normal rabbits. Fibroblasts isolated from normal and resistant rabbits exhibited differences in ($\sp{125}$I) LDL binding, HMGCoA reductase activity and ACAT activity that were similar to those found in the liver. No structural differences were found in the LDL receptor of normal and resistant fibroblasts that would account for the increased binding capacity of the resistant cells. The regulation of LDL receptor levels by exogenous oxygenated sterols was similar in normal and resistant fibroblasts. The regulation of LDL receptor binding capacity by LDL was attenuated in the resistant compared to normal fibroblasts, suggesting that the resistant fibroblasts have an alternate pathway for processing lipoprotein-derived cholesterol. Sterol-balance studies revealed that the cholesterol-fed resistant rabbits increased lithocholic acid excretion compared to the basal state, and had higher levels of deoxycholic acid excretion than cholesterol-fed normal rabbits. In addition, the specific activity and mRNA levels of cholesterol 7$\alpha$-hydroxylase (C7$\alpha$H) were higher in resistant rabbits than normal rabbits, suggesting that the increased bile acid excretion was due to an increase in bile acid synthesis. Increased clearance of cholesterol relieves the negative feedback inhibition cholesterol exerts on expression of the LDL receptor. The number of cell surface LDL receptors is then increased in resistant rabbits and allows rapid clearance of lipoproteins from the plasma compartment, thereby reducing plasma cholesterol levels. The low intracellular cholesterol level also relieves the negative feedback inhibition cholesterol exerts on HMGCoA reductase. Increased synthesis of cholesterol from acetate provides cells with cholesterol for bile acid synthesis and/or homeostasis. The activity of ACAT is then decreased due to the flux of cholesterol through the bile acid synthetic pathways. ^

Factores trombogénicos sistémicos en paciente con síndrome coronario agudo con cinecoronariografía normal y patológica

En la fisiopatología del síndrome coronario agudo (SCA) sin evidencia de lesión ateromatosa oclusiva, podría participar un estado de hipertrombogenicidad sanguínea, generado por factores trombogénicos sistémicos, como los factores de riesgo cardiovascular y los que intervienen en el balance coagulación-anticoagulación, fibrinolisis y formación de fibrina. Objetivo: Estudiar y comparar los factores trombogénicos sistémicos en pacientes con SCA y cinecoronariografía (CCG) normal y patológica.

Ultimate and failure strengths of normal muds and serpentinite muds of ODP Leg 125 samples

Serpentinite seamounts in the Mariana forearc have been explained as diapirs rising from the Benioff zone. This hypothesis predicts that the serpentinites should have low strengths as well as low densities relative to the surrounding rocks. Drilling during Leg 125 showed that the materials forming Conical Seamount in the Mariana forearc and Torishima Forearc Seamount in the Izu-Bonin forearc are water-charged serpentinite muds of density <2 g/cm**3. Wykeham-Farrance torsion-vane tests showed that they are plastic solids with a rheology that bears many similarities to the idealized Cam clay soil model and is well described by critical-state soil mechanics. The serpentinite muds have ultimate strengths of 1.3 to 273.7 kPa and yield strengths of approximately 1.0 to 50 kPa. These muds thus are orders of magnitude weaker than salt and are, in fact, comparable in density and strength to common deep-sea clay muds. Such weak and low-density materials easily become diapiric. Serpentinite muds from the summit of Conical Seamount are weaker and more ductile than those on its flanks or on Torishima Forearc Seamount. Moreover, the summit muds do not contain the pronounced pure- and simple-shear fabrics that characterize those on the seamount flanks. The seamounts are morphologically similar to shield volcanoes, and anastomosing serpentinite debris flows descending from their summits are similar in map view to pahoehoe flows. These morphologic features, together with the physical properties of the muds and their similarities to other oceanic muds and the geochemistry of the entrained waters, suggest that many forearc serpentinite seamounts are gigantic (10-20 km wide, 1.5-2.0 km high) mud volcanoes that formed by the eruption of highly liquid serpentinite muds. Torishima Forearc Seamount, which is blanketed by more ìnormalî pelagic/volcaniclastic sediment, has probably been inactive since the Miocene. Conical Seamount, which seems to consist entirely of serpentinite mud and is venting fresh water of unusual chemistry from its summit, is presently active. Muds from the flanks of Conical Seamount are stronger and more brittle than those from the summit site, and muds from Torishima Forearc Seamount are stronger yet; this suggests that the serpentinite debris flows are compacted and dewatered as they mature. The shear fabrics probably result from downslope creep and flow, but may also be inherited.

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.

Learning kinds for students of technical high school : An analysis from the David Ausubel's theory

This article presents the findings of a field research, not experimental, observational, correlating, basic, of mixed data, micro sociologic, leading to a study of surveys.The object of study is to find learning kinds, and the unit of analysis were 529 high school students between 16 and 21 years old. Its purpose is to understand the impact of learning by rote, guided, self learned and meaningful learning and its achievement degree besides the learning outcomes of differentiated curriculum based on David Ausubel's thoughts, associated with different economic specialties (MINEDUC, 1998) where the population of the study is trained. To collect data, the test TADA - DO2 was used, this test has a reliability index of 0.911 according to Cronbach. From the hits it can be stated from the null hypothesis that there is a significant association (a = 0,05) between the learning kinds and the learning expected of differentiated training plan for both, male and female. It is complex to state that the training of the middle-level technicians leads to a successful employment.

Analysis of the stress state of a halved and tabled traditional timber scarf joint with the Finite Element Method

The purpose of this study is to determine the stress distribution in the carpentry joint of halved and tabled scarf joint with the finite element method (FEM) and its comparison with the values obtained using the theory of Strength of Materials. The stress concentration areas where analyzed and the influence of mesh refinement was studied on the results in order to determine the mesh size that provides the stress values more consistent with the theory. In areas where stress concentration is lower, different mesh sizes show similar stress values. In areas where stress concentration occurs, the same values increase considerably with the refinement of the mesh. The results show a central symmetry of the isobar lines distribution where the centre of symmetry corresponds to the geometric centre of the joint. Comparison of normal stress levels obtained by the FEM and the classical theory shows small differences, except at points of stress concentration.