The Hospital Study of the City of Houston and Harris County

In 1941 the Texas Legislature appropriated $500,000 to the Board of Regents of the University of Texas to establish a cancer research hospital. The M. D. Anderson Foundation offered to match the appropriation with a grant of an equal sum and to provide a permanent site in Houston. In August, 1942 the Board of Regent of the University and the Trustees of the Foundation signed an agreement to embark on this project. This institution was to be the first one in the medical center, which was incorporated in October, 1945. The Board of Trustees of the Texas Medical Center commissioned a hospital survey to: - Define the needed hospital facilities in the area - Outline an integrated program to meet these needs - Define the facilities to be constructed - Prepare general recommendations for efficient progress The Hospital Study included information about population, hospitals, and other health care and education facilities in Houston and Harris County at that time. It included projected health care needs for future populations, education needs, and facility needs. It also included detailed information on needs for chronic illnesses, a school of public health, and nursing education. This study provides valuable information about the general population and the state of medicine in Houston and Harris County in the 1940s. It gives a unique perspective on the anticipated future as civic leaders looked forward in building the city and region. This document is critical to an understanding of the Texas Medical Center, Houston and medicine as they are today. SECTIONS INCLUDE: Abstract The Abstract was a summary of the 400 page document including general information about the survey area, community medical assets, and current and projected medical needs which the Texas Medical Center should meet. The 123 recommendations were both general (e.g., 12. “That in future planning, the present auxiliary department of the larger hospitals be considered inadequate to carry an added teaching research program of any sizable scope.”) and specific (e.g., 22. That 14.3% of the total acute bed requirement be allotted for obstetric care, reflecting a bed requirement of 522 by 1950, increasing to 1,173 by 1970.”) Section I: Survey Area This section basically addressed the first objective of the survey: “define the needed hospital facilities in the area.” Based on the admission statistics of hospitals, Harris County was included in the survey, with the recognition that growth from out-lying regional areas could occur. Population characteristics and vital statistics were included, with future trends discussed. Each of the hospitals in the area and government and private health organizations, such as the City-County Welfare Board, were documented. Statistics on the facilities use and capacity were given. Eighteen recommendations and observations on the survey area were given. Section II: Community Program This section basically addressed the second objective of the survey: “outline an integrated program to meet these needs.” The information from the Survey Area section formed the basis of the plans for development of the Texas Medical Center. In this section, specific needs, such as what medical specialties were needed, the location and general organization of a medical center, and the academic aspects were outlined. Seventy-four recommendations for these plans were provided. Section III: The Texas Medical Center The third and fourth objectives are addressed. The specific facilities were listed and recommendations were made. Section IV: Special Studies: Chronic Illness The five leading causes of death (heart disease, cancer, “apoplexy”, nephritis, and tuberculosis) were identified and statistics for morbidity and mortality provided. Diagnostic, prevention and care needs were discussed. Recommendations on facilities and other solutions were made. Section IV: Special Studies: School of Public Health An overview of the state of schools of public health in the US was provided. Information on the direction and need of this special school was also provided. Recommendations on development and organization of the proposed school were made. Section IV: Special Studies: Needs and Education Facilities for Nurses Nursing education was connected with hospitals, but the changes to academic nursing programs were discussed. The needs for well-trained nurses in an expanded medical environment were anticipated to result in significant increased demands of these professionals. An overview of the current situation in the survey area and recommendations were provided. Appendix A Maps, tables and charts provide background and statistical information for the previous sections. Appendix B Detailed census data for specific areas of the survey area in the report were included. Sketches of each of the fifteen hospitals and five other health institutions showed historical information, accreditations, staff, available facilities (beds, x-ray, etc.), academic capabilities and financial information.

Trans fatty acid intake among the population of the city of São Paulo, Brazil

OBJECTIVE: To analyze the monounsaturated and polyunsaturated trans fatty acid intake among the general population. METHODS: A cross-sectional study was conducted in São Paulo, Southeastern Brazil, in 2003, on a representative sample of 2,298 male and female subjects, including 803 adolescents (12 to 19 years), 713 adults (20 to 59 years) and 782 elderly people (60 years or over). Food intake was measured using 24-hour recall. Mean trans fatty acid intake was described according to gender and age group. RESULTS: The mean trans fatty acid intake was 5.0 g/day (SE = 0.1), accounting for 2.4% (SE = 0.1) of total energy and 6.8% (SE = 0.1) of total lipids. The adolescents had the highest mean intake levels (7.4 g/day; 2.9% of energy) while the adults and the elderly had similar intake (2.2% of energy for both; 6.4% of lipids and 6.5% of lipids, respectively). The mean trans fatty acid intake among adult and elderly women (approximately 2.5% of energy and 7.0% of lipids) was higher than among men in the same age group. The food item with the highest contribution towards trans fatty acids was margarine, accounting for more than 30% of total intake, followed by filled cookies among adolescents and meat among adults and the elderly. CONCLUSIONS: The trans fatty acid intake is above the level recommended by the World Health Organization. Replacement of the trans fatty acids in manufactured food items may be an effective measure for reducing trans fatty acid intake in Brazil.

Microscopic analysis of "prato", "mussarela" and "mineiro" cheese sold in street markets of the City of S. Paulo, Southeastern Brazil

INTRODUCTION: Cheese should be produced from ingredients of good quality and processed under hygienic conditions. Further, cheese should be transported, stored and sold in an appropriate manner in order to avoid, among other things, the incorporation of extraneous materials (filth) of biological origin or otherwise, in contravention of the relevant food legislation. The aim of the study was to evaluate the hygienic conditions of "prato", "mussarela", and "mineiro" cheeses sold at the street food markets in the city of S. Paulo, Brazil. MATERIALS AND METHOD: Forty-seven samples of each of the three types of cheese were collected during the period from March, 1993 to February, 1994. The Latin square was used as a statistical model for sampling and random selection of the street markets from which to collect the cheese samples. The samples were analysed for the presence of extraneous matters outside for which purpose the samples were washed and filtered and inside, for which the methodology of enzymathic digestion of the sample with pancreatine, followed by filtering,was used. RESULTS AND CONCLUSION: Of the 141 samples analysed, 75.9% exhibited at least one sort of extraneous matters. For the "prato" and "mussarela" cheeses, the high number of contaminated samples was due mainly to extraneous matters present inside the cheese, whereas in the "mineiro" cheese, besides the internal filth, 100% of the samples had external filth.

Trans fatty acid intake among the population of the city of São Paulo, Brazil

OBJECTIVE: To analyze the monounsaturated and polyunsaturated trans fatty acid intake among the general population. METHODS: A cross-sectional study was conducted in São Paulo, Southeastern Brazil, in 2003, on a representative sample of 2,298 male and female subjects, including 803 adolescents (12 to 19 years), 713 adults (20 to 59 years) and 782 elderly people (60 years or over). Food intake was measured using 24-hour recall. Mean trans fatty acid intake was described according to gender and age group. RESULTS: The mean trans fatty acid intake was 5.0 g/day (SE = 0.1), accounting for 2.4% (SE = 0.1) of total energy and 6.8% (SE = 0.1) of total lipids. The adolescents had the highest mean intake levels (7.4 g/day; 2.9% of energy) while the adults and the elderly had similar intake (2.2% of energy for both; 6.4% of lipids and 6.5% of lipids, respectively). The mean trans fatty acid intake among adult and elderly women (approximately 2.5% of energy and 7.0% of lipids) was higher than among men in the same age group. The food item with the highest contribution towards trans fatty acids was margarine, accounting for more than 30% of total intake, followed by filled cookies among adolescents and meat among adults and the elderly. CONCLUSIONS: The trans fatty acid intake is above the level recommended by the World Health Organization. Replacement of the trans fatty acids in manufactured food items may be an effective measure for reducing trans fatty acid intake in Brazil.

STUDY OF THE PREVALENCE OF Capillaria hepatica IN HUMANS AND RODENTS IN AN URBAN AREA OF THE CITY OF PORTO VELHO, RONDÔNIA, BRAZIL

Introduction: Hepatic capillariosis, caused by Capillaria hepatica (Calodium hepaticum) (Bancroft, 1893), Travassos, 1915 (Nematoda, Trichinelloidea, Capillariidae), is a common zoonosis in rodents but is rare in humans. Seventy-two cases in humans have been reported worldwide since the first case was described by MACARTHUR in 192417,27. This study aimed to determine the prevalence of Capillaria hepatica in humans and rodents in an urban area of Porto Velho, the capital of Rondônia, in Brazil. Methods: After conducting a census of the area, 490 residents were randomly selected, and, after signing a term of consent, provided blood samples that were screened for anti-Capillaria hepatica antibodies. Simultaneously, rats were captured to assess the prevalence of this parasite in rodents by histopathological examination in liver sections. Results: A prevalence of 1.8% was found among residents who had specific antibodies at a dilution of 1:150, indicating exposure to parasite eggs; 0.8% of the subjects also had positive titers at a dilution of 1:400, indicating true infection. The prevalence in rats was 2%. Conclusions: The prevalence of infection with this parasite among humans and rats was low. While the prevalence encountered among humans was within the limits reported in the literature, the prevalence among rodents was much lower.

Assessment of the effects of the expansion of the city of Estarreja on the rational land use

The management of urban environment, together with the preservation of the natural environment and the creation of a sustainable built environment, is a complex challenge for contemporary societies. In the name of progress, cities are contributing for the degradation of all surrounding ecosystems. Therefore there is an arising demand for developing new strategies and a new urban development paradigm settled in the search for the equilibrium between natural and built environments and efficient use of resources. The objective of this paper is to analyse how the urban expansion of the city of Estarreja took place in relation to the land use, based on the land capability classification maps of the area. Based in the results some sustainable development strategies that might be applied to the city are discussed. The obtained results demonstrate that the city has been growing faster then its population, consuming vast portions of land, since its growth as been occurring in a linear form. Despite this fact, results show that most of this expansion took place towards a territory of lower agricultural potential, when comparing to the location of its original settlement.

Characterization of late antique and early medieval pottery production of the city of Braga and its territory

The fundamental goal we set ourselves when developing this study is to try to characterize, both technically and formally, ceramics made in the city of Braga and its territory from the initial moments of the Late Antiquity to the Middle Ages. Thus, we will focus on analyzing some own productions that appear attached to the phases of late antique occupation —ceramics of red engobes and late gray—, as well as in the early medieval containers identified in different archaeological interventions practiced in the Braga environment. Concretely, we will analyze the material from various excavations conducted recently at the Theatre in the solar number 20/28 and 36/56 from the Afonso Henriques Street and the former District Hostel as well as the church of São Martinho de Dume.

Estrategia de vida implementada por un grupo de productores frutihortícolas del cinturón verde de la ciudad de Córdoba. Life strategies implemented by a group of fruit-horticultural producers from the green belt of the city of Córdoba.

Este proyecto estudiará las estrategias de vida implementadas por familias productoras fruti hortícolas que viven en Colonia Tirolesa y Chacra de la Merced, lugares que forman parte del cinturón verde de la Ciudad de Córdoba; y su relación con los procesos de diferenciación social, asociados a cambios productivos, económicos, culturales y sociales que están condicionados por el modelo de expansión capitalista. A partir del análisis del capital económico, social, cultural y simbólico se identificará en un contexto rural las motivaciones, logicas productivas y conocimientos agrícolas que incidieron en las decisiones asumidas ante problematicas emergentes, tales como limitaciones para adquirir nuevos paquetes tecnológicos, el impacto ambiental causados por la no conservación y sustentabilidad de los recursos y las consecuencias sociales vinculadas a los laxos de familia, el trabajo y la calidad de vida.Se plantean las siguientes hipótesis: 1)Algunas familias productoras implementaron estrategias de vida que se relacionan con criterios de autosustentabilidad, conocimientos agrícolas tradicionales y pautas culturales.2) Los nuevos espacios productivos no son compatibles con agroecosistemas sustentables. 3) Las nuevas tecnologías causaron impactos en la actividad productiva e incidieron en la economía, calidad de vida y vinculos familiares. 4)El modo de producción familiar fue reemplazado por el modo de producción capitalista lo que incidió en la producción agrícola y en la conservación de los recursos.El objetivo principal es descubrir las estrategias de vida implementadas por un grupo de familias, trabajadoras fruti hortícolas, en respuesta a las transformaciones productivas, tecnológicas y socio económicas impuestas por el modelo de acumulación vigente.Para ello se caracterizará los ambitos productivos de trabajo a campo, identificando la disponibilidad de capital y los conocimientos técnicos y de manejo. También se analizarán las pautas y valores culturales, el impacto de las nuevas tecnologías y la incidencia social, vinculada a los cambios en los modos de producción.El abordaje será de tipo cualitativo, recavando información para elaborar una descripción detallada de las estrategias de vida adoptadas a partir de la década de los noventa. Se tomará como unidad de análisis a las familias que trabajaron o trabajan en la producción de hortalizas o frutales. Se realizarán combinaciones entre procedimientos Tipológicos a Priori; Históricos Comparativos y casos Unitarios. Se analizará las normativas vigentes en relación al uso y calidad del agua y del suelo; también imágenes satelitales para analizar los procesos de cambio en el uso del territorio y del recurso suelo. Se pretende realizar un aporte relacionado con el conocimiento de: la sustentabilidad de los sistemas productivos, la pobreza y los modos de vida de los productores fruti hortícolas que persistencia en ambientes degradados; en una franja intermedia entre el campo y la ciudad.

Prevalencia de Trastornos Mentales en consultantes de Centros de Atención Primaria de la Ciudad de Córdoba, Argentina.Prevalence of Mental Disorders among Consultants in Primary Health Care Centers of the City of Córdoba, Argentina

El informe de la Organización Mundial de la Salud (2001), refiere que en un plazo de 20 años los trastornos mentales pasarán a ser la segunda causa dentro de la carga de morbilidad a nivel mundial, y en la actualidad una de cada cuatro personas padece de algún trastorno mental en alguna etapa de su vida. Los estudios realizados en diversos países revelan que una proporción importante de los consultantes de la atención primaria en salud presentan algún tipo de trastornos mentales. Desde esta perspectiva, la atención primaria de la salud ofrece una oportunidad de intervenir en el manejo de los trastornos mentales de forma temprana y eficaz. En Argentina, es limitada la información acerca del registro epidemiológico en salud mental, no contando con estudios abordados desde la Atención Primaria en la provincia de Córdoba. El objetivo general del proyecto es estimar la prevalencia de trastornos mentales entre los consultantes de atención primaria por problemas de salud general. Para ello se propone: Estimar la prevalencia de trastornos mentales en una muestra representativa de consultantes adultos por problemas de salud general, de centros de atención primaria de la ciudad de Córdoba, identificar y describir los tipos de trastornos mentales que presentan estos consultantes adultos de centros de atención primaria y analizar la prevalencia de los trastornos mentales por sexo y edad de la población en estudio. Metodología: el estudio se realizará en consultorios de Atención Primaria de Salud distribuídos en todo el éjido de la ciudad, teniendo en cuenta la representación de las 12 zonas de CPC. La muestra es probabilística, estratificada, polietápica de pacientes que consultan en el primer nivel de atención. Se entrevistarán 1200 pacientes utilizando la versión computorizada del CIDI 3.0, que proporciona diagnóstico de acuerdo a la DSM IV y la CIE-10. La confiabilidad y la validez del instrumento ha sido ampliamente documentada y la traducción de la encuesta al español fue realizada conforme a las recomendaciones de la OMS. El análisis efectuado será de prevalencia de Trastornos Mentales y del Comportamiento (TMC),asociación entre factores sociodemográficos y TCM estimados calculando las razones de disparidad (odds ratio), regresión logística a fin de ajustar los resultados por la posible interacción entre variables, análisis de la asociación de todas las variables con los TMC, análisis univariado de la asociación de cada variable con los TMC, controlando sexo y edad, se construirá un modelo de regresión logística. En todos los casos el nivel de significación será de 0,05. El equipo de trabajo, de cooperación internacional entre profesionales de la UNC y de la Universidad de Chile, y con la participación en colaboración de los profesionales dependientes de la Secretaría de Salud de la municipalidad de Córdoba, representa un avance para trabajar en los centros de salud de esta ciudad, constituyéndose en un avance, cualitativo y cuantitativo de la actividad científica en Atención Primaria en salud mental con abordaje epidemiológico. Se espera contribuir al conocimiento acerca de la prevalencia de los problemas de salud mental de esta población en la ciudad de Córdoba, proporcionando información a los funcionarios y responsables por la gestión de las áreas vinculadas a la salud mental, aportando conocimiento que promueva una temprana identificación de riesgos iniciales en salud mental y conductas de cuidado en la población como potencial de bienestar.Así mismo, se espera sistematizar una experiencia que pueda ser replicada en otros sitios geográficos. Por todo lo anterior, esta propuesta permitirá conocer por primera vez en la ciudad de Córdoba la frecuencia y características de los problemas de salud mental entre consultantes de Atención Primaria, información fundamental para el desarrollo posterior de estrategias que busquen mejorar la detección y el tratamiento de estos problemas. According to the WHO Report (2001), in 20 years, mental health disorders (MHDs) will be the world’s second most frequent cause of morbidity. Primary care offers the opportunity to handle MHDs efficiently at an early stage. In Argentina, the epidemiologic data on mental health (MH) is limited, and there are no records for Córdoba. The aim of this project is to assess the prevalence of MHDs among consultants who resort to primary health centers (PHCCs) in the city of Córdoba for common health problems, by using a representative sample of adult consultants, identifying and describing the types of MHDs evinced, and analysing prevalence by sex and age group under study. Methodology:the study will be carried out in PHCCs located in the municipal area of Córdoba, covering the 12 zones corresponding to the CPCs (municipal branch offices for each zone). A multi-stage stratified random sample of 1200 patients will be interviewed using the program CIDI 3.0 to produce a diagnostic according to DSM IV and CIE-10, a tool with proven reliability and validity.The aspects to be analysed are prevalence of mental and behavior disorders, their association with socio-demographic factors estimated by odds ratios, logistic regression for adjustment of potential interaction among variables, association with all variables, and univariate analysis for association with each variable. Significance level will be 0.05 in all cases. The international teamwork including professionals from the Universities of Córdoba, Chile and the Public Health Department of the Municipality of Córdoba constitutes a qualitative and quantitative step forward in the field of primary health care studies with an epidemiologic approach. This project aims at providing administrators in the MH area with data for the early detection of initial risks in MH and the promotion of prevention habits. This will be the first study conducted in Córdoba, and is aimed at facilitating replication in other geographical areas.

Report on Special Investigation of the City of Van Horne, June 01, 2000 - December 31, 2002

City Audit Report, Special Investigation

Report on Special Investigation of the City of Preston Library, June 14, 1999 - August 25, 2003

City Audit Report - Special Investigation

Report on Special Investigation of the City of Bussey Library, For the period July 1, 2003 through March 15, 2004

City Audit Report - Special Investigation

Report on Special Investigation of the City of Liscomb, For the Period June 1, 2002 through November 30, 2004

City Audit Report - Special Investigation