Browsing by Subject "United States"
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Item Can we prevent epidemics of West Nile encephalitis?(2013-09-27) Haley, Robert W.Item Comparing Smoking Behaviors Between France and the United States: A Historical and Cultural Analysis(2021-03-18) Dang, Christine; Mihalic, Angela; dela Cruz, Adriane; Sterling, KymberleBACKGROUND: The early 20th century represented a time of remarkable growth for the tobacco industry. After the link between smoking and lung cancer was solidified in the mid 20th century, smoking prevalence in developed countries has largely decreased. However, a subset of developed countries has not seen as large a decrease in smoking rates. The reasons for this divergence in smoking prevalence patterns have not been fully explored in the literature. France is one of the countries that has shown a decrease in smoking prevalence, yet their smoking prevalence is still much higher at 30% when compared to other developed countries such as the United States at 16%. These high rates of smoking in the general public also coincide with high rates amongst health professionals. Smoking status in health professionals has real effects on patient care--namely through decreased likelihood to engage in cessation counseling and less favorable perceptions of the importance of counseling. OBJECTIVE: This thesis will explore the effects of American and French government regulations on the usage of tobacco cigarettes in two time periods (1964-2009, and 2009-present day), the cultural ties to smoking and their change over time, prevalence of smoking amongst healthcare professionals, and the public health implications tied with physician smoking status. METHODS: Historical analysis was performed on legislation passed by the American and French government from 1964 - present day, different forms of media promoting tobacco usage, and physician smoking patterns and counseling practices. Sources in both the French and English language were used, and included but were not limited to research articles, book chapters, newspaper articles, and official government reports. RESULTS: The findings of this literature review suggest that compared to the United States, France has higher rates of smoking due to delayed government action at the height of the tobacco epidemic and cultural attachment to cigarette use. Both France and the U.S. have cultural ties to cigarette smoking. However, in France, the association of smoking with national identity through cigarette marketing tactics and the birth of café culture in the 1960s are large reasons why high smoking rates persist. The U.S.'s success in decreasing smoking rates over the latter half of the 20th century could largely be attributed to the stigma created around smoking and tobacco use, increasing the awareness of the medical complications of smoking by cultural icons, and mass public health campaigns. Though more prevalent in France, physician smoking remains an issue in both countries and is associated with decreased rates of cessation counseling and negative perceptions regarding the utility of cessation counseling. However, French patients are more likely to experience these negative downstream effects as France has higher smoking rates amongst physicians. CONCLUSION: This review provides a different perspective from previous literature in that it not only compares French and American government action, but it also analyzes the cultural underpinnings of tobacco use as well as its public health implications. Furthermore, it has revealed many areas in which both the United States and France could improve their public health strategies in combatting the tobacco epidemic as well as reasons why high smoking rates continue to persist in France.Item A Comparison of HIV/AIDS Management in the US and Brazil: Historical Context and Lessons Learned(2020-03-16) Zou, Michael; Mihalic, Angela; Kitchell, Ellen; Lazarte, SusanaBACKGROUND: Since its initial appearance in the early 1980s, the HIV pandemic has presented a worldwide challenge not just in biomedical innovation but in social and political mobilization as well. The groundbreaking innovation of HAART (highly active antiretroviral therapy) in 1996 was buttressed by an era of public health mobilization to limit the scale of the epidemic prior to 1996 and an era to ensure access to this treatment. The actions taken in these two eras have shaped the current character of the epidemic in all countries; the US and Brazil are no different. On the one hand, the US lags behind its countries in metrics such as the UN AIDS 90-90-90 initiative. In contrast, Brazil has emerged as the leader in Latin America in the 90-90-90 metric, achieving marks that are comparable to the US despite differing levels of development. OBJECTIVE: Brazil implemented bold public health policies that led to it becoming one of the leaders in Latin America in HIV management. This thesis will explore the historical context and implementation of these policies with an eye towards possible application in the US. METHODS: Historical analysis was performed on the public health policies of Brazil and the US regarding HIV/AIDS management. Sources include but are not limited to contemporaneous newspapers, presidential recordings and speeches, congressional legislation and briefings, documentaries, epidemiologic figures, interviews, government and activist images and posters, mathematical models of the HIV epidemic, and other studies comparing the two countries. RESULTS: To a much greater extent in the United States, there was alignment in values and action between federal and local governments, civil society, the Constitution, and international donors. This led to the historic and controversial decree in 1996, proclaiming universal and free HAART for all Brazilians. Since then, Brazil has maintained a successful and solvent HIV program through partnerships with community leaders to increase outreach, aggressive negotiation for medication pricing internationally, and sophisticated centralized databases permitting cutting-edge patient care and research. In contrast, the early HIV movement in the United States was characterized by conflict between the federal government and activists who fought for recognition and treatment for people living with HIV (PLWHIV). Other branches of the federal government in addition to local governments provided some leadership, but the lack of a unified response led to an increase in the scope of the epidemic, ultimately making it more difficult to manage. Both countries find their HIV programs at a crossroads. In Brazil, an increasingly conservative government and a defunding of the public health system (SUS) has led to a disturbing increase in incidence, especially among the youth of Brazil. In contrast, the United States has reinvigorated its domestic response to AIDS with the 'National HIV/AIDS Strategy' of President Obama and the 'Ending the Epidemic' initiative of President Trump. However, ultimate success in the HIV epidemic in the US may require a more fundamental rethinking of the healthcare system. CONCLUSION: Prior work comparing the the the Brazilian and American response to the HIV epidemic have centered on the roles of activism, executive leadership, and international factors that have shaped policies, in particular the policy of universal and free HAART in Brazil. This thesis builds on this work by examining interventions that Brazil has implemented in the last decade with an examination of recent policies enacted by the Obama, Trump, and Bolsonaro administrations. Such a comparative approach may prove useful to policymakers interested in using the experiences of other nations to devise innovative approaches to the HIV epidemic.Item Comparison of Pre-Transplant Criteria and Outcomes for Living Donor Kidney Transplant Programs in India and the United States(2015-01-26) Bansal, Sukriti; Raja, Hari; Rajora, Nilum; Kher, VijayBACKGROUND: One of the greatest obstacles to treatment of end stage renal disease globally is organ donor shortage. While some nations (i.e. the US), have primarily cadaveric organ donors, developing nations rely heavily on living donors. This project is a comparison of two kidney transplants programs -- one in the US & one in India -- looking at the pre-transplant criteria of each & assessing the patient outcomes. METHODS: This is a cohort study of living donor kidney transplant patients from St. Paul University Hospital in Dallas, TX & kidney transplant patients from Medanta the Medicity in Gurgaon, India. Data for India was collected from a database of all patients who underwent a kidney transplant at Medanta, selected for patients who fit the following criteria: one cohort of patients had been transplanted the previous month (N=29), one cohort had been transplanted one year prior the date of the study (N=29), & one cohort had been transplanted 3 years prior (N=13). Information from the database was used to calculate patient & graft survival rates for the relevant time periods. Data for St. Paul was obtained from the Scientific Registry of Transplant Recipients, which already had the calculated 1 month, 1 year, & 3 year patient and graft survival rates. Information on pre-transplant criteria was obtained from the transplant teams at each respective institution. RESULTS: The majority of medical pre-operative criteria between the two programs are identical. One significant difference is ABO-incompatible transplants are performed at Medanta, while at St. Paul ABO-incompatible donor/recipient pairs are referred for paired donation. Medanta requires all living donors to be related, while St. Paul will accept unrelated donors. The patient survival rates for St. Paul are 100% (1 mo, N=32), 95.23% (1 yr, N=32) and 85.71 % (3 yr, N=21). Graft survival rates are 100% (1 mo, N=32), 95.24% (1 yr, N=32), and 81.82% (3 yr, N=22). The patient survival rates for Medanta are 100% (1 mo., N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). Graft survival rates are 100% (1 mo. N=29), 100% (1 yr, N=29), and 100% (3 yr, N=13). For all patients transplanted at Medanta, the overall patient survival rate was 98.40% (N=874) and the overall graft survival rate was 98.51% (N=874). Corresponding data wasn't available for St. Paul. CONCLUSION: While it appears that the 3 year survival rates are better for Medanta than for St. Paul, there is a limitation on making conclusions because this data does not encompass the entire program at Medanta. Further study is needed to truly assess if there is a significant difference. The overall conclusion is that transplant programs in both settings have successful outcomes.Item The cost of dying in America(2023-06-09) Terauchi, StephanieItem Donald W. Seldin, M.D., Research Symposium finalist presentations(2021-04-23) Arvind, Ashwini; Elias, Roy; McAdams, Meredith; Salazar, Alonso Pezo; Rao, Shreya; Sheth, RahulThis edition of the UT Southwestern Internal Medicine Grand Rounds features presentations by the six Foster Fellows selected as finalists from the Sixth Annual Donald W. Seldin, M.D. Research Symposium, which was held on April 23, 2021. These Foster Fellows presented work that spanned the breadth and depth of scholarly activity across the department, and at the close of Grand Rounds, one will be selected as the 2021 Seldin Scholar, in honor of Dr. Donald W. Seldin. The Grand Rounds presentation also includes additional awards honoring Clinical Vignettes and an award for work in Quality and Education at Parkland Hospital.Item [News](1980-03-19) Harrell, Ann; McKay, CarolItem [News](1980-04-22) Harrell, Ann; McKay, CarolItem [News](1980-02-26) Harrell, Ann; McKay, CarolItem [News](1980-03-19) Harrell, Ann; McKay, CarolItem [News](1980-04-28) Harrell, Ann; McKay, CarolItem [News](1980-03-26) Harrell, Ann; McKay, CarolItem [News](1980-04-09) Harrell, Ann; McKay, CarolItem [News](1980-03-19) Harrell, Ann; McKay, CarolItem Optimizing inflammatory bowel disease clinical care and research at UTSW(2016-03-11) Kwon, John H.Item Recommended adult immunization schedule - United States, October 2006-September 2007(2007-09-28) Hardy, Robert; Centers for Disease Control and PreventionItem Sexually transmitted diseases: why should we bother?(2017-02-03) Barnes, ArtiItem [UT News](1986-07-30) Harrell, AnnItem [UT News](1985-10-01) Lyon, PamelaItem [UT News](1986-10-31) Harrell, Ann; Nolan, Cari