Identfying predictors of St. Louis encephalitis activity in Houston Texas

Generalized linear Poisson and logistic regression models were utilized to examine the relationship between temperature and precipitation and cases of Saint Louis encephalitis virus spread in the Houston metropolitan area. The models were investigated with and without repeated measures, with a first order autoregressive (AR1) correlation structure used for the repeated measures model. The two types of Poisson regression models, with and without correlation structure, showed that a unit increase in temperature measured in degrees Fahrenheit increases the occurrence of the virus 1.7 times and a unit increase in precipitation measured in inches increases the occurrence of the virus 1.5 times. Logistic regression did not show these covariates to be significant as predictors for encephalitis activity in Houston for either correlation structure. This discrepancy for the logistic model could be attributed to the small data set.^ Keywords: Saint Louis Encephalitis; Generalized Linear Model; Poisson; Logistic; First Order Autoregressive; Temperature; Precipitation. ^

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among dental professionals

Background. MRSA (methicillin-resistant Staphylococcus aureus) is a multi-drug resistant bacterium that is quite prevalent in social environments where close person-to-person contact and crowding are an issue. In dental settings, the likelihood of transmission of MRSA may be higher than among other healthcare practitioners because of the close proximity between a patient's nose (where MRSA colonizes) and the field of procedure (the mouth) to the dental professional. Objective. To estimate the prevalence of MRSA nasal colonization among dental professionals (dentists and dental hygienists) in the Greater Houston Metropolitan Area, Texas, and analyze its associations with demographic, professional and personal protective equipment-related variables. Methods. 800 dental professionals (400 dentists and 400 dental hygienists) were randomly selected in the Greater Houston Metropolitan Area. Multiple waves of nasal swab kits and a self-administered questionnaire were mailed to increase the response rate of the study population. The swabs were cultured on chromagenic agar growth medium and bacterial growth results were evaluated after 18 hours. Positively selected bacterial colonies were confirmed as MRSA by further culturing these isolated bacteria on blood agar plates. Associations between positive nasal swabs and self-reported professional practice patterns, personal protective equipment use and demographics were analyzed using multiple logistic regression. Main Results. Completed questionnaires and nasal swabs were received from 496 study participants (68%). Fourteen cultures were positive for MRSA (4.2% among dentists and 1.6% among dental hygienists, p=0.07). After adjusting for gender, dental hygienists had a significantly lower prevalence of nasal colonization of MRSA as compared to dentists (OR: 0.20, 95% CI: 0.05–0.75). No other significant associations or interactions were found. Conclusion. The prevalence of nasal colonization with MRSA among dentists is similar to that reported for health care workers in general, whereas prevalence among dental hygienists is only slightly above that of the general population (1%). Differences in practice patterns and use of personal protective equipment did not explain this difference in this study, and was possibly due either to residual confounding or unexplored risk factors. Increased prevalence of MRSA among dentists warrants further investigation as to the reason for the increased rate and to allow implementation of measures to avoid transmission and progression to disease. ^

Endemic tuberculosis, the homeless, and public transportation: A merging of geographical information systems surveillance and the Houston Tuberculosis Initiative Surveillance project

To reach the goals established by the Institute of Medicine (IOM) and the Centers for Disease Control's (CDC) STOP TB USA, measures must be taken to curtail a future peak in Tuberculosis (TB) incidence and speed the currently stagnant rate of TB elimination. Both efforts will require, at minimum, the consideration and understanding of the third dimension of TB transmission: the location-based spread of an airborne pathogen among persons known and unknown to each other. This consideration will require an elucidation of the areas within the U.S. that have endemic TB. The Houston Tuberculosis Initiative (HTI) was a population-based active surveillance of confirmed Houston/Harris County TB cases from 1995–2004. Strengths in this dataset include the molecular characterization of laboratory confirmed cases, the collection of geographic locations (including home addresses) frequented by cases, and the HTI time period that parallels a decline in TB incidence in the United States (U.S.). The HTI dataset was used in this secondary data analysis to implement a GIS analysis of TB cases, the locations frequented by cases, and their association with risk factors associated with TB transmission. ^ This study reports, for the first time, the incidence of TB among the homeless in Houston, Texas. The homeless are an at-risk population for TB disease, yet they are also a population whose TB incidence has been unknown and unreported due to their non-enumeration. The first section of this dissertation identifies local areas in Houston with endemic TB disease. Many Houston TB cases who reported living in these endemic areas also share the TB risk factor of current or recent homelessness. Merging the 2004–2005 Houston enumeration of the homeless with historical HTI surveillance data of TB cases in Houston enabled this first-time report of TB risk among the homeless in Houston. The homeless were more likely to be US-born, belong to a genotypic cluster, and belong to a cluster of a larger size. The calculated average incidence among homeless persons was 411/100,000, compared to 9.5/100,000 among housed. These alarming rates are not driven by a co-infection but by social determinants. The unsheltered persons were hospitalized more days and required more follow-up time by staff than those who reported a steady housing situation. The homeless are a specific example of the increased targeting of prevention dollars that could occur if TB rates were reported for specific areas with known health disparities rather than as a generalized rate normalized over a diverse population. ^ It has been estimated that 27% of Houstonians use public transportation. The city layout allows bus routes to run like veins connecting even the most diverse of populations within the metropolitan area. Secondary data analysis of frequent bus use (defined as riding a route weekly) among TB cases was assessed for its relationship with known TB risk factors. The spatial distribution of genotypic clusters associated with bus use was assessed, along with the reported routes and epidemiologic-links among cases belonging to the identified clusters. ^ TB cases who reported frequent bus use were more likely to have demographic and social risk factors associated with poverty, immune suppression and health disparities. An equal proportion of bus riders and non-bus riders were cultured for Mycobacterium tuberculosis, yet 75% of bus riders were genotypically clustered, indicating recent transmission, compared to 56% of non-bus riders (OR=2.4, 95%CI(2.0, 2.8), p<0.001). Bus riders had a mean cluster size of 50.14 vs. 28.9 (p<0.001). Second order spatial analysis of clustered fingerprint 2 (n=122), a Beijing family cluster, revealed geographic clustering among cases based on their report of bus use. Univariate and multivariate analysis of routes reported by cases belonging to these clusters found that 10 of the 14 clusters were associated with use. Individual Metro routes, including one route servicing the local hospitals, were found to be risk factors for belonging to a cluster shown to be endemic in Houston. The routes themselves geographically connect the census tracts previously identified as having endemic TB. 78% (15/23) of Houston Metro routes investigated had one or more print groups reporting frequent use for every HTI study year. We present data on three specific but clonally related print groups and show that bus-use is clustered in time by route and is the only known link between cases in one of the three prints: print 22. (Abstract shortened by UMI.)^

Child Welfare Workers’ Perceptions of the Influence of the Organizational Environment on Permanency Decisions for Families

The findings of this study suggest that while child welfare workers are consistently distracted by competing priorities from unexpected events, most are committed, and to understand perspectives is more inclusive and may improve retention rates. Notably, while it is recognized that permanency decisions are not made in an intellectual, legal or clinical vacuum and certain traditional aspects of the bureaucratic structure do not impact decision making, this study advances the body of knowledge on child welfare decision making. Examined in this study are child welfare case workers’ perceptions of the extent to which the organizational environment influences the permanency decisions they make to reunify or terminate parental rights of children placed out-of-home. This study includes a sample of 95 child welfare social workers employed in three public child welfare agencies in the Baltimore and Washington, DC metropolitan area. It used a cross-sectional research design, employing a survey instrument to examine bureaucratic distraction, role conflict, and supervisory adequacy as contextual factors in the organizational environment's influence on permanency outcome decisions. Implications are made for child welfare policy, practice, and research.

Booster Breaks in the workplace: Effects on employee stress

The current study examined the effects of a 15-minute daily physical activity break on the stress levels of white collar employees. An innovative group physical activity program, the Booster Break, was implemented in two worksites, both located in a large metropolitan area. One hundred sixteen participants were randomly assigned to one of three conditions; 43 participants were assigned to the Booster Break condition, 40 participants were assigned to an individual, computer-based physical activity condition, and 32 were assigned to a no-physical activity control condition. Self-report and objective measures were taken at baseline and after the completion of the intervention. There were no significant differences among conditions in perceived stress or blood pressure after the intervention. However, the data showed trends in the direction predicted with a decrease in perceived stress among Booster Break (change in perceived stress = -0.1) and computer prompt participants (change in perceived stress = -0.2) and an increase in perceived stress among the control group (change in perceived stress = 0.2). More research is recommended to fully understand the effects of worksite physical activity on stress.^

El CIFOT como apoyo a la gestión gubernamental : efectos socioeconómicos frente a la construcción de la presa Potrerillos.

El objetivo de este estudio es conocer la realidad de los pobladores y su entorno en el área que ahora ocupa el embalse de Potrerillos y su zona de influencia, con diferentes niveles de detalle, para minimizar los efectos negativos sobre la población y conseguir la información imprescindible para la planificación de la zona. Además de la villa de Potrerillos, Cacheuta y Alto Potrerillos se vieron afectadas en su situación social y económica por los cambios originados a partir de la creación del espejo de agua. El CIFOT firma convenio con el Ministerio de Ambiente y Obras Públicas del Gobierno de Mendoza para realizar un trabajo de relevamiento (Junio-Noviembre 1998) para conocer los factores físicos del lugar - aptitudes y susceptibilidades-, la realidad socioeconómica de los pobladores, actividades recreativo – turísticas, infraestructura y equipamiento, como también las relaciones entre localidades, datos que se tienen en cuenta al momento de buscar soluciones para relocalizar la población de la Villa Potrerillos.

Comparing the quality of three models of postabortion care in public hospitals in Mexico City

artículo publicado en la revista Int Fam Plan Perspect. 2003 Sep;29(3):112-20

Women’s experiences with the use of medical abortion in a legally restricted context: the case of Argentina

This article presents the findings of a qualitative study exploring the experiences of women living in Buenos Aires Metropolitan Area, Argentina, with the use of misoprostol for inducing an abortion. We asked women about the range of decisions they had to make, their emotions, the physical experience, strategies they needed to use, including seeking health care advice and in dealing with a clandestine medical abortion, and their overall evaluation of the experience. An in-depth interview schedule was used. The women had either used misoprostol and sought counselling or care at a public hospital (n=24) or had used misoprostol based on the advice of a local hotline, information from the internet or from other women (n=21). Four stages in the women’s experiences were identified: how the decision to terminate the pregnancy was taken, how the medication was obtained, how the tablets were used, and reflections on the outcome whether or not they sought medical advice. Safety and privacy were key in deciding to use medical abortion. Access to the medication was the main obstacle, requiring a prescription or a friendly drugstore. Correct information about the number of pills to use and dosage intervals was the least easy to obtain and caused concerns. The possibility of choosing a time of privacy and having the company of a close one was highlighted as a unique advantage of medical abortion. Efforts to improve abortion law, policy and service provision in Argentina in order to ensure the best possible conditions for use of medical abortion by women should be redoubled.

Entre la planificación urbana y las ciencias sociales : la Comisión de Desarrollo Urbano y Regional de CLACSO (1967-1973)

El artículo aborda la constitución y despliegue de la Comisión de Desarrollo Urbano y Regional de CLACSO en tanto red regional entre 1967 y 1973. En el marco de disputas entre distintos saberes expertos sobre la ciudad, se abordará cómo la Comisión replantea las relaciones entre planificación urbana y regional y ciencias sociales y, en términos más amplios, los vínculos entre técnica y política. Asimismo, como parte de la construcción de objetos de investigación trasnacionales, se analiza su intento de construir una programa latinoamericano sobre la investigación urbana y regional y cómo contactos previos construidos en universidades norteamericanas son reutilizados por integrantes de la comisión a los fines de expandirse y acceder a financiamiento. Finalmente, se indica cómo acontecimientos políticos en la región impactan sobre la comisión rearticulando su organización. El artículo se apoya en el análisis de fuentes primarias y secundarias.

The Darién Region, Connecting Road of the Americas, among the expressions of hydric wealth, land vocation and the extractive exploration on its violated forms

Colombia has oceanic waters, catchment areas, like lakes, cienagas and swamps, water flows, like rivers, gorges and streams, small rivers and groundwater. The oceanic waters are the Caribbean Sea-1600 km and the Pacific Ocean-1300 km that comprise the north and west continental territory, respectively. Actually the Region of Darién, geographically bounded by the Carribean Sea to the north is becoming to be focused by studies due to use conflicts and disputes about water and a forest reserve on its territories. Considering its location, strategic at northwestern Colombia, frontier region with Central America, several dynamics are imposed. One of them is the implantation of a road system entitled Connecting Road of the Americas. This fact means the construction of an infra-structure that will cross a special zone formed by swamps and jungle known as The Darién Gap. Evidences of such interests are revealed by projects like the constructions of Turbo's Port in the Atlantic Ocean, Department of Antioquia and Tribugá's Port in the Pacific Ocean, Department of Choco, the mountain road and the coastal conection Colombia-Venezuela attending to the main intentions of the central region of the department (Metropolitan Area of Aburrá Valley-AMVA). Human settlements form a productive system, based on small and medium familiar agriculture's production, corresponding to the western portion and piedmont of Abibe's mountain at its antioquian portion, alluvial plan that forms the rivers on this area, the littoral zone that delimits the Carribean Sea, the Darién and Baudó Mountains and the gulf that receives, among other waters, the ones from Atrato and León, as well as the exodus process constitutes a forced exit resulting from actions of several armed groups. It can be identified intense historical, cultural, political and environmental relations, specially the last one associated with strategic ecosystems that are fundamental for the hydric regulation of the region, as well as food safety of the local inhabitants. Results from two researches (UPB, 2007 y 2010) reveals this quick transformation in the spatial re-configuration, demographical and economical indicators and the exacerbated fight for resources, damaging the extractive vocation in the Region. Path to commerce of illegalities (drugs, guns) and to implementation of the agroindustrial project for biofuel production, cooperation program that involves Venezuela, Brazil and Colombia. Appropriation modes allow the existence of strategies since global interests revealing a development logic that privileges the conception of an artificialized nature. Since the smallest portion of rural areas, specific modes of resources exploration are linked to imposed interests of transnational corporations. Disparate consequences are going deeper evidenced by social, technical and nature transformations, envisioning risks for the habitability's condition

Transformaciones habitacionales en la Región Metropolitana de Buenos Aires : El pasaje del neoliberalismo al neodesarrollismo urbano

La recuperación de la economía argentina luego de la crisis del 2001/02 implicó una importante mejora de múltiples indicadores sociales y económicos, dada entre otros factores, la orientación de políticas públicas tendiente a recuperar el tejido productivo y el empleo. En este contexto, el tándem construcción-obra pública se transformó en un tema central de la agenda y la expansión inmobiliaria fue bien recibida desde la mirada macroeconómica. Sin embargo, este proceso no estuvo exento de contradicciones, y se observan en la región metropolitana un conjunto de tendencias concurrentes producto de la hibridación entre el neoliberalismo urbano aún vigente y la difusión del neodesarrollismo urbano. De allí que la ampliación de acciones de desmercatilización estatal del consumo de bienes y servicios orientados a la reproducción social coexiste con la persistencia del proceso de desmercatilización social regresivo de la producción del espacio habitacional, junto a la intensa mercantilización del espacio construido asociada a la creciente financierización de los ladrillos

Narrativas y reflexividad : Los efectos biográficos del enfoque biográfico

En el presente artículo reflexionamos acerca de las potencialidades y efectos biográficos del enfoque biográfico, y en particular de la técnica de relatos de vida. Para ello, nos valemos de las significaciones de jóvenes de barrios vulnerabilizados del Area Metropolitana de Buenos Aires (AMBA) que participaron -como entrevistados y co-autores de sus relatos biográficos- de una experiencia de investigación, en el marco de un proyecto UBACyT. En particular, recuperamos expresiones que refieren a la forma en que los jóvenes conciben (y vivencian) la situación de entrevista y los efectos biográficos que supone la experiencia de co-construcción y apropiación, por parte de los entrevistados, de sus relatos de vida. El análisis del corpus discursivo construido (entrevistas y relatos biográficos) nos permitió identificar tres efectos en la vida de los entrevistados que emergieron como consecuencia de su participación en una investigación que empleó el enfoque biográfico en su vertiente interpretativista: el efecto reflexivo, el efecto identitario y el efecto vincular

"La recuperación es para obedientes" : Algunas articulaciones y ajustes metodológicos para el análisis de un tratamiento de adicción a las drogas

El escrito reflexiona sobre la adecuación teórica y metodológica del recurso a las categorías institución total, dispositivo y disciplina, para investigar problemáticas recientes en el campo de la salud-enfermedad-atención, particularmente las denominadas adicciones a las drogas. De la mano de numerosas investigaciones empíricas, ciertos conceptos se anudan en los análisis, asociándose disciplina-encierro, e institución total-espacio cerrado. El escrito propone el desacople de estas nociones y la recuperación de su productividad analítica, desde la investigación en un dispositivo terapéutico ambulatorio para la adicción a drogas del Area Metropolitana de Buenos Aires. Se aborda esta problemática desde una perspectiva etnográfica, con análisis documental, observación participante y entrevistas realizadas a profesionales de la salud de la institución, personal de apoyo y usuarios. Se concluye que las formulaciones de Goffman y Foucault ayudan a comprender la existencia de modalidades de tratamiento para las adicciones a las drogas que, sin fundarse en el encierro como técnica primordial de control de los cuerpos, sostienen un proceso de clausura y despojo significativos; y que la renuncia a homologar la clausura, y el espacio cerrado a una materialidad, permitió dar realce a una vivencia de despojo subjetivo de parte de quienes se encuentran en tratamiento en la institución

Transformaciones habitacionales en la Región Metropolitana de Buenos Aires : El pasaje del neoliberalismo al neodesarrollismo urbano

La recuperación de la economía argentina luego de la crisis del 2001/02 implicó una importante mejora de múltiples indicadores sociales y económicos, dada entre otros factores, la orientación de políticas públicas tendiente a recuperar el tejido productivo y el empleo. En este contexto, el tándem construcción-obra pública se transformó en un tema central de la agenda y la expansión inmobiliaria fue bien recibida desde la mirada macroeconómica. Sin embargo, este proceso no estuvo exento de contradicciones, y se observan en la región metropolitana un conjunto de tendencias concurrentes producto de la hibridación entre el neoliberalismo urbano aún vigente y la difusión del neodesarrollismo urbano. De allí que la ampliación de acciones de desmercatilización estatal del consumo de bienes y servicios orientados a la reproducción social coexiste con la persistencia del proceso de desmercatilización social regresivo de la producción del espacio habitacional, junto a la intensa mercantilización del espacio construido asociada a la creciente financierización de los ladrillos

Transformaciones habitacionales en la Región Metropolitana de Buenos Aires : El pasaje del neoliberalismo al neodesarrollismo urbano

La recuperación de la economía argentina luego de la crisis del 2001/02 implicó una importante mejora de múltiples indicadores sociales y económicos, dada entre otros factores, la orientación de políticas públicas tendiente a recuperar el tejido productivo y el empleo. En este contexto, el tándem construcción-obra pública se transformó en un tema central de la agenda y la expansión inmobiliaria fue bien recibida desde la mirada macroeconómica. Sin embargo, este proceso no estuvo exento de contradicciones, y se observan en la región metropolitana un conjunto de tendencias concurrentes producto de la hibridación entre el neoliberalismo urbano aún vigente y la difusión del neodesarrollismo urbano. De allí que la ampliación de acciones de desmercatilización estatal del consumo de bienes y servicios orientados a la reproducción social coexiste con la persistencia del proceso de desmercatilización social regresivo de la producción del espacio habitacional, junto a la intensa mercantilización del espacio construido asociada a la creciente financierización de los ladrillos