Clinical decisions related to CBC screening of asymptomatic full-term infants at risk for group B streptococcus disease

Objective. Although complete blood count (CBC) changes occur with the development of clinical sepsis in newborns, the CBC has not been reported to be a sensitive predictor of sepsis in asymptomatic full-term newborn infants, nor has it been reported to be related to risk factors for sepsis or clinical decisions. The objective of this study was to evaluate the relationship between the WBC/I:T (immature:total neutrophil) ratio and maternal group B streptococcal (GBS) risk factors (rupture of membranes ≥18 hours, maternal temperature ≥100.4°F, maternal age ≤20 years, previous infant with invasive GBS disease, maternal GBS bacteriuria, and black ethnicity); and to evaluate the relationship between the WBC/I:T ratios and providers' clinical decisions (observe versus repeat the CBC or complete sepsis evaluation) in the asymptomatic full-term newborn at risk for early-onset GBS sepsis. ^ Methods. Medical records of infants admitted to the well baby nursery at a tertiary care teaching hospital in Houston, TX between 1/1/99 and 12/31/00 whose gestational ages were ≥35 weeks; who had mothers with GBS positive or unknown culture status and inadequate intrapartum antibiotic prophylaxis; and who had screening CBCs performed in the first 30 hours of life because of GBS risk were reviewed (n = 412). Demographic information, maternal GBS risk factors, CBC results, clinical decisions, and rationales for clinical decisions were collected. ^ Results. With the exception of black ethnicity (p = .0000, odds ratio = 0.213), no statistically significant differences in risk factors between infants with normal and abnormal WBC counts or normal and abnormal I:T ratios were found. Infants with abnormal WBCs had a significantly higher likelihood of having a CBC repeated (p = 0.002 for WBC). Providers documented the CBC result in the rationale for clinical decisions in 62% of the cases. ^ Conclusion. The CBC results were not related to maternal risk factors for GBS except for ethnicity. Black infants had significantly lower WBC levels than infants of other ethnicities, although this difference was clinically insignificant. Infants with abnormal WBCs had a significantly higher likelihood of undergoing repeat CBCs but not sepsis evaluations. Provider rationale was difficult to evaluate due to insufficient documentation. The screening CBC result did not impact the clinicians' decisions to initiate sepsis evaluations in this population. ^

Policy analysis of the Americans with Disabilities Act of 1990 and federal funding concerning barrier-free playgrounds

The Americans with Disabilities Act (ADA) of 1990 was created to prohibit discrimination against disabled persons in our society. The goal of the ADA as a comprehensive civil rights law is to "ensure equal opportunity and complete participation, independent living and economic self-sufficiency" for disabled persons (U.S. Department of Justice, 2008). As part of Title II and III of the ADA, states and local governments are required to provide people with disabilities the same chance to engage in and benefit from all programs and services including recreational facilities and activities as every other citizen. Recreational facilities and related structures must comply with accessibility standards when creating new structures or renovating existing ones. Through a systematic literature review of articles accessed through online databases, articles relating to children with disabilities, their quality of life and their experience gained through play were reviewed, analyzed and synthesized. Additionally, the ADA's Final Rule regarding accessible playgrounds was evaluated through a descriptive analysis which yielded the following five components relating the importance of barrier-free playgrounds to children with disabilities: appropriate dimensions for children, integration of the play area, variety of activity and stimulation, availability of accessible play structures to communities, and financial feasibility. These components were used as evaluation criteria to investigate the degree to which the ADA's Final Rule document met these criteria. An evaluation of two federal funding sources, the Urban Parks and Recreation Renewal Program (UPARR) and the Land and Water Conservation Fund (LWCF), was also conducted which revealed three components relating the two programs' ability to support the realization of the ADA's Final Rule which included: current budget for the program, ability of local communities to attain funds, and level of ADA compliance required to receive funding. Majority of the evaluation of the Final Rule concluded it be adequate in development of barrier-free playgrounds although there are some portions of the guidelines that would benefit from further elucidation. Both funding programs were concluded to not adequately support the development of barrier-free playgrounds and therefore it was recommended that their funding be re-instated or increased as necessary. ^

The relationship between physical activity and perceived built environment factors among adult Mexican Americans living in Brownsville, Texas

Background. Physical Activity (PA) is a central part in the fight to reduce obesity rates that are higher in Mexican Americans in the United States than any other ethnic groups. More than half of all Americans do not meet the daily PA recommendations and 48% of Mexican Americans do not exercise. The built environment is believed to affect participation in physical activity. The influence of the built environmental on physical activity levels in low-income Mexican Americans living along the Texas-Mexico border has not been investigated. ^ Purpose. The purpose of this secondary data analysis was trifold: (1) to determine the levels of self-reported PA in adults living in Brownsville, Texas; (2) to characterize the perceptions of this population regarding the built environment; and (3) to determine the association between self-reported PA and the built environment in Mexican Americans living in Brownsville, Texas. ^ Methods. 400 participants from the Tu Salud ¡Sí Cuenta! (TSSC) community-wide campaign were included in this secondary data analysis. Percentages for level of physical activity and the built environment were calculated using SPSS. Perceptions of the built environment were assessed by 14 items. Logistic regression analysis was used to assess the relationship between physical activity and built environment. All models were adjusted for age, gender, and level of education. ^ Results. The majority of men (41.97%) and women (59%), combined (56.7%)did not meet the 2008 PA Guidelines for Americans. We analyzed 14 built environment variables to characterize participants’ perceptions of the built environment. We conducted odds ratio (OR) to find if those who met PA levels associated the built environment such as neighborhood shops ([OR:1.806], CI:1.074,3.038 ]) bus stops ([OR:1.436], CI:.806,2.558) unattended stray dogs ([OR: 1.806], CI:1. 074,3.038), sidewalk access ([OR: .858],CI:.437,1.686), access to free parks ([OR:.549],CI:.335,.900) heavy traffic in neighborhood ([OR:.802], CI:.501,1.285), crime rate ([OR:.779], CI:.494,1.228) ranked the highest by mean score. The association between physical activity and the perceived built environment factors for Mexican Americans participating in the TSSCStudy were weakly associated. ^ Conclusions. This study provides evidence that PA levels are low in this Mexican American population. The built environment factors assessed in this study characterized the need for further studies of the variables that are seen as important to the Mexican American population. Lastly, the association of PA levels to the built environment was weak overall and further studies are recommended of the built environment.^

Has the development of a New Urbanist community affected the physical activity levels of residents in surrounding neighborhoods?

Study Aims. The neighborhood environment has been shown to influence physical activity levels, but little is known about how far-reaching these effects are. This study sought to determine whether or not the development of a New Urbanist community in Austin, Texas affected the physical activity levels of residents in surrounding neighborhoods. The results were stratified by demographic characteristics, residential distance from the New Urbanist community, and type of physical activity to determine if any observed changes varied by these factors.^ Methods. Self-report questionnaires were mailed to a random sample of households located within one mile of the New Urbanist development. The questionnaire included questions about physical activity behaviors before and after the community was constructed in 2006. Changes in reported levels of physical activity between the two time points were examined.^ Results. The prevalence and average minutes per week of total physical activity did not change. Significant increases in the frequency and quantity of moderate-intensity leisure-time physical activity were observed. The amount of time spent walking and biking for recreation outside of the neighborhood increased significantly among those living close to Mueller. The weekly time spent in vigorous-intensity activity increased significantly, especially among those living closer to Mueller. There were significant decreases in the prevalence of and time spent walking for transport. The use of Mueller parks and trails was highest among participants living close to Mueller.^ Conclusions. The nearby Mueller development does not appear to have encouraged sedentary members of the surrounding population to become physically active, but might be associated with increased weekly physical activity among those who were already active. The increase in vigorous-intensity physical activity and recreational walking/biking outside of the neighborhood among those subjects living closer to Mueller may be attributed to the use of Mueller parks and trails, which was also considerably higher among this group. People may be substituting the time they spent walking for transport before the Mueller development with moderate-intensity leisure-time physical activity. Future research should seek to identify barriers that may be preventing more nearby residents from using Mueller facilities for physical activity. ^

An evaluation of a Lake Houston tributary, Cypress Creek, for contamination and water quality

Introduction. Lake Houston serves as a reservoir for both recreational and drinking water for residents of Houston, Texas, and the metropolitan area. The Texas Commission on Environmental Quality (TCEQ) expressed concerns about the water quality and increasing amounts of pathogenic bacteria in Lake Houston (3). The objective of this investigation is to evaluate water quality for the presence of bacteria, nitrates, nitrites, carbon, phosphorus, dissolved oxygen, pH, turbidity, suspended solids, dissolved solids, and chlorine in Cypress Creek. The aims of this project are to analyze samples of water from Cypress Creek and to render a quantitative and graphical representation of the results. The collected information will allow for a better understanding of the aqueous environment in Cypress Creek.^ Methods. Water samples were collected in August 2009 and analyzed in the field and at UTSPH laboratory by spectrophotometry and other methods. Mapping software was utilized to develop novel maps of the sample sites using coordinates attained with the Global Positioning System (GPS). Sample sites and concentrations were mapped using Geographic Information System (GIS) software and correlated with permitted outfalls and other land use characteristic.^ Results. All areas sampled were positive for the presence of total coliform and Escherichia coli (E. coli). The presences of other water contaminants varied at each location in Cypress Creek but were under the maximum allowable limits designated by the Texas Commission on Environmental Quality. However, dissolved oxygen concentrations were elevated above the TCEQ limit of 5.0 mg/L at majority of the sites. One site had near-limit concentration of nitrates at 9.8 mg/L. Land use above this site included farm land, agricultural land, golf course, parks, residential neighborhoods, and nine permitted TCEQ effluent discharge sites within 0.5 miles upstream.^ Significance. Lake Houston and its tributary, Cypress Creek, are used as recreational waters where individuals may become exposed to microbial contamination. Lake Houston also is the source of drinking water for much of Houston/Harris and Galveston Counties. This research identified the presence of microbial contaminates in Cypress Creek above TCEQ regulatory requirements. Other water quality variables measured were in line with TCEQ regulations except for near-limit for nitrate at sample site #10, at Jarvis and Timberlake in Cypress Texas.^

Examining seasonal variations in physical activity among low-income Hispanic walk-trail users living in the Cameron Park Colonia

This study examines variations in physical activity by season, and within seasons by age and gender among park users living in the Cameron Park Colonia, a low-income Hispanic community along the Texas-Mexico border. This is the first study of its kind to evaluate seasonal variations by physical activity among a Hispanic population. We hypothesized that (1) there are no differences in overall physical activity by season; (2) youth engage in more sport-related physical activity compared to adults, (3) males engage in more physical activity than females, and (4) there are differences in physical activity between walk-trail users compared to non walk-trail users in the park.^ Physical activity behavioral data was collected (males n=2,093; females n=1,014) at two time periods (winter 2007; summer 2007) via direct observations and assessed park use, walking trail use, and physical activity (moderate-to-vigorous physical activity (MVPA) by seasons. Frequencies for physical activities were calculated for gender, age groups, and season. Separate Pearson's chi-square analyses were used to address variations in physical activity, age, gender, intensity level of physical activity by season, between walk-trails users and non walk-trail users.^ People visiting the park engaged in more sedentary behavior in winter than summer and a higher percentage engaged in MVPA in the summer than winter (p<.05). More females engaged in light activity compared to males (p<.05). Walk-trail users consisted mostly of females and engaged in more light activity than non walk-trail users (p<.05) who participated in more MVPA.^ Increasing access to parks and walk-trails may be an intervention strategy to increase physical activity among Hispanics. More research is needed to assess promoting trail use and determining long-term effects on physical activity among minority/ethnic groups at greater risk of a sedentary lifestyle and reasons for trail use and non-use. Future studies should focus on the types of activities Hispanics engage in at different parks particularly between men and women. As a result of this study city officials and planners may use this information to build and design parks that cater to the types of activities that Hispanics engage in and may use to meet physical activity guidelines.^

Understanding Impediments and Enablers to Physical Activity among African American Adults: A Systematic Review of Qualitative Studies

Objective: To systematically assess and summarize impediments and facilitating factors impacting physical activity participation among African American Adults. ^ Method: A systematic search of the literature was conducted, which included electronic databases, as well as reference list of relevant papers. Only qualitative studies which measured race and ethnicity and had African American as adult participants were included. The main themes and categories from the qualitative studies pertaining to impediments and facilitators to physical activity were identified and summarized, through descriptive meta-synthesis. ^ Result: Twenty nine qualitative studies were included. Twenty-one of the studies only focused on adult African American women, and the barriers and facilitators to physical activity as perceived by them. The biggest individual enabler towards physical activity was the positive health benefits associated with regular physical activity. Social support and easy access to parks and facilities were also identified as enablers. Barriers toward physical activity were lack of time, lack of motivation, long work hours, and physical disabilities. ^ Conclusions: The findings of this review study should be useful to those planning an intervention in African American communities. There is also a need for qualitative studies conducted only among African American men, to better understand their perspective on the facilitators and barriers to physical activity.^

Impact of consciousness raising and social liberation on readiness to engage in regular physical activity among adults in Magnolia Park/Lawndale-Wayside, Houston, TX

According to the transtheoretical model, consciousness raising and social liberation are processes used to help individuals progress through the stages of change for a given behavior. This study assessed the impact of these two processes on readiness to engage in regular physical activity among a convenience sample of 35 adults in the Magnolia Park/Lawndale-Wayside area of Houston, TX. The duration of the study was approximately 4 weeks. All pre/post-test data were collected via self-administered surveys available in English or Spanish. Baseline data were used to determine the culturally relevant content of a one-dose intervention consisting of a presentation and dissemination of educational materials as well as a list of local physical activity opportunities. Although the intervention did not improve progression through the stages of change, significant increases were evident among 5 out of 6 processes of change. Based on these results and qualitative data, this study recommended that the Houston Parks and Recreation Department incorporate cultural competency into the design and publication of materials and revise the schedule of available programs (i.e.: increase the number of walking programs) in order to reflect the physical activity preferences of Magnolia Park/Lawndale-Wayside residents.^

Flora y vegetación de céspedes de parques públicos : Mendoza (Argentina)

Se analizó la flora y la vegetación de céspedes de parques públicos de Mendoza (Argentina) a fin de aportar información para su manejo. Se registraron 73 especies, incluidas en 65 géneros y 24 familias. Las Poaceae, Asteraceae, Fabaceae y Brassicaceae representaron el 58,9 % de la flora de los céspedes. El 67,1 % de las especies son introducidas; el resto son nativas. Dominaron las perennes: 54,8 %, sobre las anuales: 42,5 % y bienales: 2,7 %, así como las estivales: 75,3 % sobre las invernales. Estructuralmente también lo hicieron las terófitas: 42,5 %, sobre las hemicriptófitas: 27,4 %, geófitas: 21,9 %, caméfitas: 5,5 % y helófitas: 2,7 %. Se determinaron 33 comunidades y se identificaron las clases fitosociológicas Molinio- Arrhenatheretea R. Tx. 1937 (campos húmedos y pisoteados, con vegetación subnitrófila e higrófita) y Stellarietea mediae R. Tx. 1950 (vegetación arvense de los cultivos). Las comunidades vegetales de Trifoliun repens más Cynodon dactylon, Lolium multiflorum más Cynodon dactylon y Cynodon dactylon fueron las de mayor extensión y coberturas de los céspedes.

Los árboles y arbustos indígenas cultivados como ornamentales en la ciudad de Mendoza y alrededores

En el presente trabajo los autores pasan en revista treinta y cuatro representantes indígenas de la Flora Argentina cultivados como ornamentales en la ciudad de Mendoza y alrededores, señalando su ubicación en parques, plazas, calles y paseos y aportando datos sobre fuste, floración, fructificación y viabilidad de sus semillas en base a observaciones directas de muchos años y a materiales de herbario, reunidos al efecto.

Análisis del proceso de creación de los Parques Nacionales en Argentina

Este artículo tiene por objetivo analizar y caracterizar el proceso histórico de creación de los parques nacionales en Argentina, desde sus inicios hasta la actualidad, por parte de la autoridad de aplicación, la Administración de Parques Nacionales, tomando como marco conceptual las principales corrientes teóricas en conservación que se fueron sucediendo a lo largo del tiempo. Junto a las fechas de creación de los parques nacionales, su posición geográfica y las ecorregiones donde se localizan, permitieron establecer tres períodos que estuvieron signados por la implementación de políticas públicas en la materia, enmarcadas dentro de los lineamientos generales de dichas corrientes teóricas. Asimismo, se esboza un breve estado de la situación de la preservación en las ecorregiones de nuestro país y, finalmente, se exponen las conclusiones.

Amorales, patoteros, chongos y pitucos. La homosexualidad masculina durante el primer peronismo (Buenos Aires, 1943-1955)

Este artículo estudia la identificación de los homosexuales varones como un grupo singular durante la primera década peronista, bajo la figura de los "amorales". A diferencia de principios de siglo XX, donde estaban integrados en el caótico ambiente de la mala vida. Los varones de mediados de siglo que tenían relaciones sexuales con varones comenzaron a ser destacados como una desviación peligrosa del ideal familiarista y heterosexista. Este proceso se explica a través de la masculinización de la clase obrera operada por el peronismo y la aparición contemporánea de los jóvenes como un sector social problemático y peligroso. Se estudia este desarrollo de la intolerancia comenzando en los primeros años '40 hasta llegar a las razzias antihomosexuales de 1954-1955 en las calles, bares y plazas de Buenos Aires. A diferencia de otras interpretaciones que subrayan el carácter ancilar de las batidas policiales, sostenemos que fueron más que una excusa en el combate del peronismo contra el catolicismo, pues se inscribían en tensiones más profundas del orden social, sexual y simbólico de la Argentina de posguerra.

Alternativas ante el conflicto entre autoridades ambientales y habitantes de áreas protegidas en páramos colombianos

Colombia es uno de los países denominados megadiversos biológica y culturalmente. Presenta a su interior la mayor extensión de páramos del mundo, los cuales son considerados fábricas de agua del planeta y hábitats de rica diversidad biológica. Por otro lado, la ocupación humana de los páramos colombianos ha generado conflictos entre las normativas ambientales vigentes y los usos productivos del suelo. El presente artículo analiza las alternativas aplicadas ante el conflicto entre autoridades ambientales de áreas protegidas y habitantes de los páramos en Colombia. Se encontraron dos tipos de alternativas: la primera plantea la concesión de servicios ecoturísticos en los parques naturales y la compra de tierras por parte de sociedades de economía mixta. La segunda plantea el abandono de las actividades productivas de los agricultores, mediado por procesos educativos o de cumplimiento de las normas ambientales vigentes, so pena de enfrentar acciones punitivas por parte del Estado. Este trabajo presenta una tercera alternativa, que parte de la crítica a las dos anteriores e incluye diferentes estrategias: planes de manejo comunitario con tiempo y financiación institucional pertinente, aplicación de modelos agroecológicos y rescate de la memoria biocultural y cambios en la estructura agraria.

Transformaciones en el empleo y el territorio : El caso San Luis

Los procesos económicos y sociales producen efectos territoriales. Cada territorio expresa dichos procesos de manera específica y distintiva de acuerdo con su historia productiva y con las prácticas y estrategias de los diferentes agentes sociales involucrados en la gestión de los cambios. Si bien estos procesos se enmarcan en un conjunto de tendencias globales que sirven de contexto a las diversas respuestas, en algunos casos estas sólo pueden comprenderse adecuadamente teniendo en cuenta las características distintivas del territorio particular. En la Provincia de San Luis, a lo largo de las últimas dos décadas, la producción del territorio estuvo signada por las transformaciones ocurridas a partir de la puesta en marcha de los planes nacionales de promoción industrial, que afectaron a todas las dimensiones de la vida social. En efecto, esta nueva situación no sólo cambió la orientación productiva de la provincia, sino que impactó también sobre los comportamientos individuales y familiares que, a nivel agregado, determinan el nivel y las fluctuaciones de la dinámica demográfica. Particularmente, se verificó un desplazamiento poblacional hacia los parques industriales de los principales centros urbanos de la provincia y, consecuentemente, un despoblamiento de las áreas rurales. De esta manera, la industrialización tuvo una nueva expresión territorial, que conformó nuevos paisajes de segregación y nuevas formas de exclusión. A mediados de la década de 1990, frente a la finalización de los beneficios promocionales, se implementó una serie de políticas públicas, encaminadas a la búsqueda de nuevos perfiles productivos, que generaron nuevos impactos sobre la organización territorial. Este trabajo propone un análisis de esos procesos, tomando especialmente en cuenta que las transformaciones en el empleo y el territorio se impactan mutuamente. Vale decir: las transformaciones en la competitividad territorial se expresan en problemas de empleo y de mercado de trabajo y, a su vez, los cambios en el empleo generan fuertes cambios en la perspectiva de un área territorial

Análisis del proceso de creación de los Parques Nacionales en Argentina

Este artículo tiene por objetivo analizar y caracterizar el proceso histórico de creación de los parques nacionales en Argentina, desde sus inicios hasta la actualidad, por parte de la autoridad de aplicación, la Administración de Parques Nacionales, tomando como marco conceptual las principales corrientes teóricas en conservación que se fueron sucediendo a lo largo del tiempo. Junto a las fechas de creación de los parques nacionales, su posición geográfica y las ecorregiones donde se localizan, permitieron establecer tres períodos que estuvieron signados por la implementación de políticas públicas en la materia, enmarcadas dentro de los lineamientos generales de dichas corrientes teóricas. Asimismo, se esboza un breve estado de la situación de la preservación en las ecorregiones de nuestro país y, finalmente, se exponen las conclusiones.