Browsing by Subject "Texas"
Now showing 1 - 20 of 52
- Results Per Page
- Sort Options
Item 2016-2017 Graduate School of Biomedical Sciences Catalog(University of Texas Southwestern Medical Center, 2017)Item 2016-2017 Medical School Catalog(University of Texas Southwestern Medical Center, 2017)Item 2016-2017 School of Health Professions Catalog(University of Texas Southwestern Medical Center, 2017)Item 2017-2018 Graduate School of Biomedical Sciences Catalog(University of Texas Southwestern Medical Center, 2018)Item 2017-2018 Medical School Catalog(University of Texas Southwestern Medical Center, 2018)Item 2017-2018 School of Health Professions Catalog(University of Texas Southwestern Medical Center, 2018)Item 2018-2019 Graduate School of Biomedical Sciences Catalog(University of Texas Southwestern Medical Center, 2019)Item 2018-2019 Medical School Catalog(University of Texas Southwestern Medical Center, 2019)Item 2018-2019 School of Health Professions Catalog(University of Texas Southwestern Medical Center, 2019)Item 2019-2020 Graduate School of Biomedical Sciences Catalog(University of Texas Southwestern Medical Center, 2020)Item 2019-2020 Medical School Catalog(University of Texas Southwestern Medical Center, 2020)Item 2019-2020 School of Health Professions Catalog(University of Texas Southwestern Medical Center, 2020)Item 2020-2021 Graduate School of Biomedical Sciences Catalog(University of Texas Southwestern Medical Center, 2021)Item 2020-2021 Medical School Catalog(University of Texas Southwestern Medical Center, 2021)Item 2020-2021 School of Health Professions Catalog(University of Texas Southwestern Medical Center, 2021)Item Acres of Diamonds: Rediscovering Community Assets in Dallas Backyards(2016-04-01) Chavda, Avinash Suresh; Rhee, Chanhaeng; Reed, W. GaryBACKGROUND: Diabetes directly affects 8% of the US population and poses a growing burden to healthcare providers, to the health system, and to society. Cultivating self-efficacy enhances personal agency and enables patients to take an active role in the management of their disease. Effectively cultivating self-efficacy among patients from diverse backgrounds requires a patient-tailored assessment of existing gaps in patients' diabetes self-management skills. Tying patients to existing community health resources through ZIP code-based mapping is an effective patient-tailored intervention that creates long lasting change in diabetes self-management. To this end, a two-armed approach to community resource mapping was taken: In the first arm, existing resources in the categories of exercise, nutrition, and diabetes management were catalogued and mapped across Dallas County ZIP codes; in the second arm, patient awareness of existing resources across the same three categories was mapped across Dallas County ZIP codes. A comparison of each study arm across overlapping ZIP codes showed that resources abound in Dallas, but awareness of these resources is the limiting factor in fostering increased patient self-efficacy. To increase self-efficacy and empower patients to improve self-management of their diabetes, patients should be connected with community resources to tackle the issue of underutilization of community resources and thereby gain "mastery experiences." OBJECTIVE: This project hypothesizes that community resources are plentiful in Dallas and that there is a relative lack of awareness of community resources, limiting patient self-management of diabetes. METHODS: This study mapped community assets in the categories of exercise, nutrition, and diabetes management across the Dallas ZIP codes with the heaviest burden of diabetes. This study then mapped awareness of these same resources and compared both maps to identify a disconnect between community resources and the communities they serve. RESULTS: Sample maps of community assets in several of 14 target ZIP codes were produced with the aid of Google maps, showcasing the abundance of community resources throughout the ZIP codes of Dallas County, including those with poor clinical and socioeconomic measures. Though results may not be representative of individual ZIP codes, awareness of resources appears to vary more directly with these clinical and socioeconomic measures than does true resource distribution. CONCLUSION: This study applies quality improvement and process analysis tools to empirically advance theoretical population health frameworks. Asset cataloguing and geospatial mapping demonstrate an abundance of community resources evenly distributed throughout Dallas but a dearth of resource awareness that loosely correlates with negative community measures. Such measures include median household income, BMI, HbA1C, and crime index. Continued indexing of Dallas County resources with more sophisticated mapping software will yield asset catalogues more consistent in their value to society; and continued awareness surveying is necessary to develop representative ZIP code awareness maps for deep comparison of these objective resource and subjective awareness measures.Item Association of African Ancestry with Electrocardiographic Voltage and Concentric Left Ventricular Hypertrophy: The Dallas Heart Study(2020-05-01T05:00:00.000Z) Alame, Aya J.; Drazner, Mark H.; Garg, Sonia; Kozlitina, JuliaBACKGROUND: Compared with white individuals, black individuals have increased electrocardiographic voltage and an increased prevalence of concentric left ventricular (LV) hypertrophy. Whether environmental or genetic factors lead to these racial differences is unknown. OBJECTIVE: To determine whether proportion of genetically determined African ancestry among self-reported black individuals is associated with increased electrocardiographic voltage and concentric LV hypertrophy (LVH). METHODS: The Dallas Heart Study is a probability-based cohort study of English- or Spanish-speaking Dallas County, Texas, residents, with deliberate oversampling of black individuals. Participants underwent extensive phenotyping, which included electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), and dual-energy radiography absorptiometry (DEXA) at a single center. Participants aged 18 to 65 years who enrolled in the Dallas Heart Study between July 2000 and December 2002, self-identified as black (n = 1251) or white (n = 826), and had ECG, CMR, and DEXA data were included in this analysis. Data were analyzed from June 2017 to September 2018. RESULTS: Of the 2077 participants included in the study, 1138 (54.8%) were women, and the mean (SD) age was 45.2 (9.9) years. Black race and African ancestry were individually associated with increased ECG voltage, LV concentricity^0.67, LVWT, and prevalent LVH in multivariable analyses adjusting for age, sex, systolic blood pressure, antihypertensive medication use, and body composition. When African ancestry and black race were entered together into multivariable models, African ancestry but not black race remained associated with ECG voltage, LVWT, LV concentricity0.67, and prevalent LVH. Among black participants, African ancestry remained associated with these 4 phenotypes (12-lead voltage: β, 0.05; P = .04; LVWT: β, 0.05; P = .02; LV concentricity^0.67: β, 0.05; P = .045; prevalent LVH: odds ratio, 1.2; 95% CI, 1.03-1.4; P = .02). CONCLUSION: Genetically determined African ancestry was associated with electrocardiographic voltage, measures of concentric LV remodeling, and prevalent LVH. These data support a genetic basis related to African ancestry for the increased prevalence of these cardiovascular traits in black individuals.Item Barriers to Cochlear Implantation(2021-05-01T05:00:00.000Z) Balachandra, Sanjana; Hunter, Jacob B.; Kutz, J. Walter; Isaacson, BrandonINTRODUCTION: Cochlear implantation (CI) is the most effective treatment for profound sensorineural hearing loss, despite the low utilization of CI in the United States. Only about 5-7% of CI-eligible adults pursue CI, for reasons which remain unclear. OBJECTIVE: Our research has two primary aims: 1) to identify sociodemographic disparities in CI in Texas and explore trends using an all-payer database from 2010-2017; and 2) to investigate patient-reported barriers to, and motivators for, pursuing CI. METHODS: Aim 1) The publicly available Texas Outpatient Surgical and Radiological Procedure Data was accessed to analyze outpatient CI cases in the entire state of Texas. Variables analyzed include patient age, sex, race/ethnicity, and insurance status. Population data from the American Community Survey were utilized to generate CI utilization rates by patient demographic characteristics. Insurance data was obtained from the Kaiser Family Foundation. Aim 2) A single-institutional review of CI candidates between December 2010 and December 2018 was performed to identify patients who did not pursue surgery, as well as those who pursued surgery after a delayed time period or at a different institution. A 21-question survey was developed internally, aimed at identifying and ranking patients' concerns regarding surgical risks, adaptation to the CI, time commitment to adapt, costs, loss of residual hearing, and lack of benefit. Current hearing aid usage and familiarity with other CI users were also analyzed. The survey was administered via email or telephone. RESULTS: Aim 1) 6,158 CI cases were identified during the study period. The number of CI per year nearly doubled from 497 in 2010 to 961 in 2017. The majority of CI recipients were white (59.5%), male (51.9%), and privately insured (47.9%). Patients over 75 demonstrated the greatest increase in the CI rate per 100,000 population, increasing from 4.60 in 2010 to 14.30 in 2017. All racial/ethnic groups noted an increase in the CI per 100,000 population, with white patients demonstrating the highest rate in 2017, at 4.36 CI per 100,000 population. Asian patients had a 502% increase in the CI rate (from 0.42 to 2.53), compared with 87.9%, 84.4%, and 69.2% increases for White, Black, and Hispanic populations, respectively. Medicaid recipients were the only insurance group that did not experience a statistically significant growth from 2010-2017 (3.27 to 3.49, p=0.26). Aim 2) Fifty-two survey responses were received, comprised of 27 patients who did not pursue CI and 25 patients who did. The most commonly reported barrier was a belief that CI would not significantly improve the ability to communicate, followed by concerns over the post-operative recovery process, risks of surgery, and risks of losing music appreciation. Anesthetic risk and cost were the least important reasons not to pursue CI. The most commonly reported facilitator was a belief that hearing loss was affecting job performance. CONCLUSIONS: CI became more widespread between 2010-2017; however, vast disparities exist in who benefitted most from this growth in CI. Black and Hispanic populations had lower CI per 100,000 population than their white peers, while patients >65 years of age accounted for the greatest increase in CI. Moreover, the decision not to pursue CI despite eligibility is multifactorial and includes concern for minimal hearing benefit and perioperative risks. These factors should be taken into consideration when counseling patients on CI surgery. Resources should be devoted to promote CI to disadvantaged groups as identified in our research.Item Bulletin: Southwestern Medical College of the Southwestern Medical Foundation(1948-08) Southwestern Medical CollegeItem Bulletin: Southwestern Medical College of the Southwestern Medical Foundation(1947-08) Southwestern Medical College
- «
- 1 (current)
- 2
- 3
- »