Jacques Baillargeon, PhD
Associate Professor, PMCH
Director of Research, CMC
Circulating testosterone levels decline with advancing age and are lower in older men than in younger men. Over the past decade, testosterone replacement therapy (TRT) prescriptions have increased dramatically. This trend has been driven in part by reported TRT-associated improvements in: lean muscle mass, sexual function, cognitive ability, bone density, insulin sensitivity, and energy level. The development of new drugs and improved methods of delivery—including skin patches, dermal gels, and buccal and sublingual systems —have further contributed to increased TRT use. Despite the widespread promotion and use of testosterone replacement therapy, the toxicities for this treatment have not been delineated. In recent years, TRT-associated cardiovascular adverse events has emerged as an area of particular concern and debate. Studies examining the influence of TRT on cardiovascular events, however, have yielded conflicting results. We therefore conducted a population-based cohort study of older men to examine the influence of intravenous treatment with testosterone on subsequent hospitalization for cardiovascular disease.
Mark VanLandingham, PhD
Thomas C. Keller Professor
Department of Global Health Systems and Development
Tulane University School of Public Health and Tropical Medicine
On August 29, 2005, Hurricane Katrina stuck the coastal areas of Louisiana, Mississippi, Alabama, and Florida, resulting in over 1000 deaths in Louisiana alone. Media attention has focused on the devastation of New Orleans lower ninth ward, which suffered heavy damage near one of the major levee breaks. But little attention has focused on the substantial population of recent Vietnamese immigrants living in metropolitan New Orleans, many of whom live in this same heavily-damaged ninth ward. The levee failures occurring just after Hurricane Katrina’s landfall flooded the major Vietnamese enclave in eastern New Orleans, resulting in the evacuation and dislocation of this entire immigrant community. The lecture will describe a longstanding research project focusing on this immigrant community, and will focus on changes in health status for a working-age cohort that was assessed just before the Katrina catastrophe and at several points thereafter.
MD/PhD Doctoral Candidate
Population Health Sciences, PMCH
Neighborhood racial and ethnic composition is an important factor for health, though the specific pattern of this association varies by race/ethnicity. For example, a large body of research has demonstrated that African American residential segregation is associated with several negative social and health outcomes for African American residents. In contrast, emerging research suggests that living in a Hispanic neighborhood is associated with improved health outcomes for Hispanic residents, particularly for the foreign-born. However, the beneficial effects of Hispanic neighborhood composition have been demonstrated in only a few data sets, and mechanisms of this protective effect have yet to be explored. This presentation describes dissertation work designed to address these gaps in the literature in two ways. First, we use quantitative methods to estimate the Hispanic composition—depressive symptoms relationship in the Texas City Stress and Health Study and to test three possible mechanisms—social support, perceived discrimination and perceived stress. Second, we use qualitative methods to explore the differences between living in a high and low Hispanic composition neighborhood for Mexican-descent residents of Texas City. This presentation focuses on results from the quantitative phase of the project, and describes the design for the future qualitative phase of research.
Jared Dickinson, Ph.D.
Department of Nutrition and Metabolism
Aging is characterized by a gradual loss of skeletal muscle size and function, termed sarcopenia, which promotes disability and dependence in older adults. Our laboratory’s goals are to understand the cellular mechanisms that contribute to this loss of muscle size and function, and to identify and develop therapeutic strategies to improve muscle health in older adults and clinical populations. Changes in muscle size and function are ultimately governed by an interplay between the rates of muscle protein synthesis and protein breakdown, and our lab and others have identified that nutrition and exercise represent two powerful strategies to increase muscle protein synthesis. This lecture will focus on understanding how advancing age impacts the response of skeletal muscle to exercise and nutrition, and how these powerful stimuli can be used as a therapy for improving muscle health in older adults.
Jacqueline Hirth, PhD, MPH
Center for Interdisciplinary Research in Women's Health
Obstetrics and Gynecology
Introduction: In December 2009, the American Congress of Obstetricians and Gynecologists (ACOG) recommended that Pap smears and HPV testing should not be used among females < 21 years old because detection of cervical dysplasia and human papilloma virus (HPV) is more harmful than beneficial in these groups. This study examined reductions in Pap smears and HPV testing in young women after ACOG guidelines were issued. Methods: A retrospective study using insurance claims data examined the proportion of females between 12-20 years who received a well woman exam and who also received a Pap smear or HPV test between 2008 and 2010. The frequencies of cervical dysplasia and diagnosis of high risk HPV were also examined. Results: A total of 178,899 privately insured females were identified who met the age criteria and had at least one well woman exam between 2008 and 2010. The proportion of teenagers that received a pap smear dropped from over 70% in December of 2009 to 57% in December of 2010. Although having a previous abnormal Pap test was associated with having a Pap test in 2010, receiving a previous Pap test was more strongly associated. Conclusions: Decreases in Pap testing among young women occurred after ACOG guidelines were issued. However, previous abnormal Pap results did not appear to be the main motivator for inappropriate Pap testing in 2010. Further research needs to be conducted to examine compliance since similar guidelines were adopted by the US Preventive Services Task Force and American Cancer Society in 2012.
Kenneth J. Ottenbacher, PhD, OTR
Russell Shearn Moody Distinguished Chair
Professor & Director, Division of Rehabilitation Sciences
Associate Director, Sealy Center on Aging
This presentation will discuss the need and opportunities to use large datasets in exploring rehabilitation outcomes. An example using Centers for Medicare and Medicaid Data will be presented using hospital readmission for persons receiving inpatient medical rehabilitation as the outcome. Resources available through the UTMB Center for Rehabilitation Research Using Large Datasets will be described.
Diana M. Bensyl, PhD, MA, CAPT, USPHS
EIS Field Supervisor
Epidemic Intelligence Service (EIS) Field Assignments Branch, CDC
The Youth Asset Survey (YAS) is a five-wave longitudinal study of youth-parent pairs to investigate youth risk behaviors and assets. The first wave of data was collected during 2003–2004. YAS data from year five (2008–2009), the most recent wave of data, was used for this analysis. Wave 5 included 858 respondents with pledge status and initiation of sexual activity data (mean age = 18 years; 50% female; 38% white non-Hispanic). Any type of virginity pledge was reported by 331 youth (27% of males compared to 50% of females; p < 0.001). Of those 331 youth, 156 (47%) reported they had had sex, and for the 527 youth who had not made a pledge, 428 (81%) reported they had had sex, a significant difference (p < 0.0001) indicating that taking a pledge was associated with fewer youth reporting initiating sexual intercourse. Virginity pledges were associated with decreased reporting of sexual intercourse. Differences were observed by both gender and pledge type. Understanding the role of virginity pledges in adolescent pregnancy prevention will help ensure sex education programs include best practices.
Everyone is welcome to attend.
Elizabeth Lyons, Ph.D., M.P.H.
Institute for Translational Sciences
Play of motion-controlled video games may be a way to increase physical activity and/or decrease sedentary behavior, but games are not universally active or enjoyable. Motion-controlled games may differ from traditional games on important attributes, which may affect frequency and intensity of play. These attributes may also influence snack food and caloric beverage intake, which have been found to be higher during TV watching and traditional video gaming than in no-distraction conditions. Infrequency of play and increases in snacking may be unexpected outcomes that could hinder future game-based exercise interventions; there is a need for better understanding of how and why individuals play motion-controlled games and how play affects their energy balance-related behaviors. This talk will describe two large cross-sectional studies of motion-controlled video game play in young adults. First, the effects of four different types of video games on energy expenditure and enjoyment were compared: shooter, band simulation, dance simulation, and fitness. Second, the effects of watching TV, playing traditional video games, or playing motion-controlled video games for one hour on snacking behavior and energy expenditure were compared. Finally, results of these studies will be discussed in the context of future research and game development needs.
James Graham, PhD
Division of Rehabilitation Sciences, UTMB Health
The relationship between higher patient volume and better health
outcomes is well established in acute care settings. Mortality
(survival) is the most common outcome in these studies. There is little
to no information on the volume-outcomes relationship in post acute care
settings such as inpatient rehabilitation. In addition, mortality is
not an appropriate gauge of rehabilitation success. During this
presentation we will discuss the variability in facility volumes within
the three most common inpatient rehabilitation impairment categories
(stroke, hip fracture, and joint replacement) and the association
between these volumes and rehabilitation-relevant outcomes: functional
status at discharge and discharge setting.
This talk presents findings from two studies on the new Essure,
outpatient sterilization procedure that was performed at UTMB’s Regional
Maternal Child Health clinic on predominantly Hispanic, low-income
women. The first study finds an association between sexually transmitted
infections and tubal-related failure rates through a quantitative
analysis of electronic medical records. The second study is a
qualitative analysis of in-depth interviews, and finds that relationship
factors, wanting a better future, and past reproductive histories were
major components in why women decided on the Essure sterilization.
Director, Texas Census Research Data Center
Texas A&M University
Abstract: Texas A&M University, in collaboration with consortium partners Baylor University, the Texas A&M University System, and the University of Texas at Austin, has won US Census Bureau approval and National Science Foundation funding to establish the Texas Census Research Data Center (TXCRDC) in College Station, Texas. When the facility opens in fall 2012, it will be one of only about a dozen CRDCs in the nation and the only CRDC in a region extending 800 miles in any direction from Texas A&M University.
The TXCRDC will give researchers a compelling resource for advanced research in the social, behavioral, economic, and health sciences. CRDCs provide a secure computing facility where qualified researchers with approved projects can undertake statistical analyses using non-public microdata files maintained by federal statistical agencies including the US Census Bureau, the National Center for Health Statistics, and the Agency for Healthcare Research and Quality. The richness of the data available in CRDCs makes them increasingly important for basic science and policy research in fields such as economics, business, planning, demography, and health/health disparities.
The presentation and discussion will review the opportunities that CRDCs offer researchers, the nature and realities of conducting research in this setting, and tips and strategies for winning approval to undertake projects in CRDCs. In addition, the presentation will provide an overview of the TXCRDC, the resources it will offer researchers, and the options for gaining access via institutional consortium membership or project-specific arrangements for researchers not at consortium member institutions.
For additional details about the TXCRDC see the website at http://txcrdc.tamu.edu
Jaime Benarroch-Gampel, MD General Surgery Resident, UTMB Health
There is controversy about the management of the gallbladder in patients who have bariatric surgery. Some surgeons advocate to remove the gallbladder during bariatric surgery to avoid future problems. Others preferred to leave the gallbladder intact as the majority of the patients will not develop gallbladder symptoms after surgery. This study evaluates which strategy has more benefits in relation to it cost.
Helen W Lane1, Barbara Rice2, Scott M
1NASA/Johnson Space Center, Houston, TX. 2Enterprise
Advisory Services, Houston TX
Prior to the Shuttle program, all understanding of nutritional needs in space came from Skylab metabolic research. Because Shuttle flights were short, most less than 14 days, research focused on major nutritional issues: energy (calories), protein and amino acids, water and electrotypes, with some more general physiology studies that related to iron and calcium. Using stable isotope tracer studies and diet intake records, we found that astronauts typically did not consume adequate calories to meet energy expenditure. To monitor energy and nutrient intake status and provide feedback to the flight surgeon and the astronauts, the International Space Station (ISS) program implemented a weekly food frequency questionnaire and routine body mass measurements. Other Shuttle investigations found that protein turnover was higher during flight, suggesting there was increased protein degradation and probably concurrent increase in protein synthesis, and this occurred even in cases of adequate protein and caloric intake. These results may partially explain some of the loss of leg muscle mass. Fluid and electrolyte flight studies demonstrated that water intake, like energy intake, was lower than required. However, sodium intakes were elevated during flight and likely related to other concerns such as calcium turnover and other health-related issues. NASA is making efforts to have tasty foods with much lower salt levels to reduce sodium intake and to promote fluid intake on orbit. Red blood cell studies conducted on the Shuttle found decreased erythrogenesis and increased serum ferritin levels. Given that the diet is high in iron there may be iron storage health concerns, especially related to the role of iron in oxidative damage, complicated by the stress and radiation. The Shuttle nutrition research lead to new monitoring and research on ISS. These data will be valuable for future NASA and commercial crewed missions.
"Inpatient Rehabilitation Outcomes for Patients with Debility"
Rebecca Galloway, PT, GCS
PhD candidate, Rehabilitation Sciences
Assistant Professor & DCE, Physical Therapy
Patients who experience debility, also known as deconditioning, during acute hospitalization may require inpatient rehabilitation to improve functional independence before returning to community living. Limited evidence exists to understand the longitudinal increase in debility cases and to guide rehabilitation recommendations. This presentation will focus on inpatient rehabilitation facility (IRF) outcome trends for the years 2000 to 2010 for > 250,000 admissions from the Uniform Data System for Medical Rehabilitation (UDSMR®). Key health outcomes include functional independence at admission and discharge, length of stay, and discharge setting. These trends will be discussed in the context of health care policy changes including prospective payment system and requirements to qualify as an IRF for Medicare reimbursement. Further aims utilizing data from the Centers for Medicare and Medicaid Services (CMS) are to 1) examine trends in post-IRF acute care readmission and mortality and 2) identify risk factors associated with discharge from IRF to acute care for patients with debility.
"Inpatient Rehabilitation Outcomes Following Lower Extremity Fracture in Patients with Pneumonia"
Ijaz Ahmed, MD, RRT
School of Health Professions, UTMB Health
Pneumonia is a common comorbidity among hospitalized older adults. It can impede functional restoration and increase medical costs. Accordingly, reimbursement rates through the prospective payment system for inpatient rehabilitation are slightly higher for patients within a given impairment category who also have pneumonia. Using secondary data analysis of medical records obtained from 919 facilities that subscribed to the Uniform Data System for Medical Rehabilitation (UDSMR) in 2005-2007 we assessed the associations between pneumonia comorbidity and rehabilitation outcomes in persons receiving inpatient rehabilitation services following lower extremity fracture.
Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) Sharon Petronella Croisant, Ph.D.
Cornelis Elferink, Ph.D.
Shakeel Ansari, Ph.D.
Using a Health in All Policies Strategy to Support Pro-health Recovery Planning Alexandra (Lexi) B. Nolen, PhD, MPH Director of the Center to Eliminate Health Disparities
Director ad interim of the Global Health Education Program, UTMB
Abstract: For the last two years, the Center to Eliminate Health Disparities at
UTMB has been working to strengthen pro-health planning in local
hurricane recovery efforts. This outline will present CEHD’s strategy
and priority issues to target for planning, as well as more and less
successful aspects of the project.
Role of reactive hyperemia in blood flow restriction exercise
David Gundermann, MS
Division of Rehabilitation Sciences, UTMB
Abstract: Blood flow restriction (BFR) to a contracting muscle during
low-intensity resistance exercise training increases muscle strength and
size in humans. However, the mechanism(s) responsible for how BFR
exercise causes muscle hypertrophy are not known. We have previously
shown that mTORC1 signaling and muscle protein synthesis (MPS) are
stimulated following an acute bout of BFR exercise. As nutrients are
also capable of activating mTORC1 signaling and MPS, we hypothesized
that reactive hyperemia (i.e., enhanced nutritive blood flow) following
BFR exercise would be an important mechanism for BFR exercise-induced
muscle growth. We simulated the reactive hyperemia response from BFR
exercise by infusing sodium nitroprusside (SNP), a pharmacological
vasodilator, into the femoral artery after non-restricted low-intensity
leg extension exercise. In a randomized cross-over design, the acute
post-exercise mTORC1 signaling and MPS response, from six young men (24 ±
2y), was measured in the SNP group and compared to BFR exercise (BFR
group). Post-exercise mixed muscle fractional synthetic rate from the
vastus lateralis increased by 49% in the BFR group (P<0.05) but was
unaffected in the SNP group (P>0.05). BFR exercise increased the
phosphorylation of mTOR, S6K1, rpS6, ERK1/2 and Mnk1 (P<0.05). There
were no changes in mTORC1 signaling in the SNP group (P>0.05). We
conclude that reactive hyperemia is not a primary mechanism for BFR
exercise-induced mTORC1 signaling and MPS. It remains to be determined
whether mTORC1 signaling is required for the increase in MPS and muscle
growth with BFR exercise.
HIV and Non-Communicable Diseases in sub-Saharan Africa: Challenges and Opportunities in an Era of Epidemiologic Transition Matthew Dacso, M.D, M.Sc.
Director, Center for Global Health Education
Assistant Professor, Department of Internal Medicine
University of Texas Medical Branch Premal Patel, M.D, M.Sc, AAHIVM
Associate Director, Center for Global Health Education
Assistant Professor, Department of Internal Medicine
University of Texas Medical Branch
Summary: More than 50 years after the end of the colonial era, the sub-Saharan Africa region remains in various stages of social, economic, and political transition. Health and disease patterns are also evolving in intricate ways. For many countries, advances in economic development have been offset by the devastating consequences of the HIV pandemic. Meanwhile, the health care infrastructure designed around "vertical" HIV, TB, and malaria programs is finding itself ill-equipped to handle the burden of chronic non-communicable diseases (NCDs) that occur as Africans, previously dying at a young age, now live longer. As the recent United Nations summit demonstrates, the international aid community recognizes the importance of addressing NCDs. But will international aid fall into the same patterns of disease-specific top-down program funding or can existing "horizontal" health care infrastructure be leveraged to optimize care of these complex individuals? Several approaches to managing NCDs will be addressed, including both population and individual-level perspectives.
End-of-life care in Medicare beneficiaries dying with pancreatic cancer Kristin M. Sheffield, Ph.D. Assistant Professor
Department of Surgery, General Surgery, UTMB
Hospice care improves management of symptoms and quality of life for patients at the end of life. Although hospice utilization has increased over the past two decades, many eligible patients are not enrolled in hospice or are enrolled late. Moreover, there is evidence that aggressiveness of end-of-life cancer treatment has increased, including receipt of chemotherapy, emergency room visits, hospitalizations, and intensive care unit admissions in the last month of life. This presentation will review relevant research on healthcare utilization, aggressiveness of care, and hospice enrollment in cancer patients at the end of life. Dr. Sheffield will also discuss results from a recently published study evaluating hospice enrollment and aggressiveness of care in pancreatic cancer patients at the end of life. Data from the Surveillance, Epidemiology, and End Results and linked Medicare claims data were used to examine hospice use, early enrollment in hospice, and several indicators of aggressiveness of care in the last month of life in 22,995 older patients who died of pancreatic cancer from 1992-2006.
On the Battleground of Access to Care - The story of HOPE Clinic: a community health center in Houston, Texas Charu Sawhney, D.O, M.P.H. General Internist – Preventive Medicine Clinician
The tragedy of this country’s failing health care system is acutely felt in clinics and emergency rooms everyday. 17 percent of Americans, 25% of Texans and 33% of Harris County residents are uninsured. Access to basic primary health care and preventive services is challenging and access to specialty care is extremely difficult if not impossible to achieve. How do individuals without medical coverage get the care they need? The patchwork of healthcare services and community health programs for the uninsured will be discussed through the lens of a non-profit community health center located in Southwest Houston. Upcoming changes to healthcare delivery on a local level through The Affordable Care Act will also be addressed.
UTMB Center for Rehabilitation Research using Large Datasets Kenneth J. Ottenbacher, PhD, OTR
Russell Shearn Moody Distinguished Chair in Neurological Rehabilitation
Professor & Director, Division of Rehabilitation Sciences
Director, Center for Rehabilitation Sciences
Senior Associate Dean for Graduate Research Education (SHP)
For those who are not bakers, bring a package of your favorite cookies to share.
For more information please contact PMCH GSO Chair Lawrence Panas
Reports from the Environmental Health and Toxicology Class
"Persistent Drought in Texas: Management Plan to Reduce Future Adverse Health Outcomes"
Presented by Group 2:
The possibility of anthrax to be used as a biological weapon is a reality, as terrorist organizations continue to find means of circumventing law enforcement. The event of a bioterrorist attack is likely to impact poorly prepared emergency response services, with delayed recognition and response from the local, state, and federal regulatory agencies. It is difficult to evaluate approaches to preparation; while it is possible to propose examinations for emergency personnel and health providers, and table-top drills for potential responders, the reality of the matter is that examinations and drills are difficult to require and enforce, and may not target those who will actually be called upon in the event of a bioterrorist attack. Oversight agencies should continue to encourage the education, laboratory capabilities, government cooperation, public education, and other preparation plans. Unfortunately, the reality is that, as a nation, the United States will likely continue to be unprepared for the event of a disaster involving widespread release of biological weapons. It is only by a continual reexamination of this particular environmental health threat, from the point of recognition to the management of contagion, that we can hope to respond and neutralize such a threat when it occurs. This lecture will examine the current state of readiness, opportunities for improved response, and limitations to management of anthrax as a bioterrorist weapon.
The UTMB Office of Health Policy and Legislative Affairs, Center to Eliminate Health Disparities, Department of Preventive Medicine & Community Health, UTMB Student Chapter of the American Medical Association/Texas Medical Association, and the UTMB Chapter of the American Medical Student Association
are serving up the
On the menu this month....
"LEAST Lead Initiative: The emerging story of lead poisoning in Galveston children"
Presented by: Lexi Nolen, M.P.H., Ph.D. Director, Center to Eliminate Health Disparities
Director ad interim, Global Health Program
UTMB Health, Galveston
Thursday, January 20, 2011
12:00 - 1:00 pm NEW LOCATION: Children's Hospital Auditorium 2.312
Lunch served beginning at 11:30 a.m.
Alexandra (Lexi) Bambas Nolen, PhD, MPH, serves as the Director of the Center to Eliminate Health Disparities and Director ad interim of the Global Health Program at the University of Texas Medical Branch in Galveston, Texas. In her capacity as Director of the CEHD, Dr. Nolen has developed program areas on reducing health inequities through the Health System and Social Determinants of Health, and has developed training materials on Leadership Skills for Social Change in Health as well as advanced research and training in Global Health. At the CEHD, Dr. Nolen is also currently overseeing an NIH-funded initiative to address Health in All Policies in Galveston’s local recovery efforts from Hurricane Ike. Dr. Nolen served on the Secretariat of the WHO Commission on Social Determinants of Health from 2005 – 2007, focused on advancing intersectoral action for health to reduce health inequities. Previously she was the Coordinator of the Global Equity Gauge Alliance (2002-2004), a South Africa-based non-governmental organization focused on health equity initiatives in Latin America, Africa and Asia. She has experience coordinating community-based research and interventions as well as policy development on issues of health inequities and public health in a number of country contexts
"Is neighborhood ethnic concentration associated with lower mortality among Mexican Americans?
An investigation using geocoded state vital statistics data."
Karl Eschbach, PhD
Division of Geriatrics
Department of Internal Medicine
Abstract: Studies investigating the hypothesis that neighborhood ethnic concentration is associated with better health status and lower mortality among Mexican American adults have reported inconsistent results. This study uses geo-coded vital statistics data from Texas and California to study the spatial patterning of all-cause and cause-specific mortality among Mexican Americans in relation to the distribution of ethnic concentration, poverty concentration, and immigrant composition.
Internal Medicine/Geriatric Medicine
This meeting will be broadcast via teleconference to UTMB’s geriatric clinic at Oceanview Transitional Care Center
Thursday, February 3, 2011
Rebecca Sealy Classroom, 5.100
12:00 p.m. - 1:00 p.m.
"Care Settings for People with Dementia: The Role of the Architectural Design"
Gesine Marquardt, MD
Professor & Chair of Social and Health Care Design
Dresden University of Technology Faculty of Architecture
Carbon Monoxide – The Ugly, The Bad and The Good?
Graduate Student, Population Health Sciences
Carbon monoxide (CO) has been regarded as the “silent killer” of organisms that rely on oxygen for their energy supply and survival, in part due to its colorless, odorless and tasteless nature, even at toxic doses. Paradoxically, there has been increasing evidence in most recent years that reveals that low doses of CO (50-500 ppm) may mediate a protective effect. I will present a brief overview of the spectrum of the effects of CO - from high to low doses with a focus on its cytoprotective effects in the airway and its potential for therapeutic use in asthma. Currently, there is an important need for the discovery of an alternative and effective therapy to treat airway inflammation in asthmatics, and especially in severe asthmatics. The difficulty in characterizing and treating severe asthma has led its utilization of a disproportionate amount to the overall economic burden of asthmatics worldwide. Preliminary results in human airway smooth muscle cells (HASMC) have revealed that exogenously administered CO significantly decreases the cell’s pro-inflammatory and proliferative response both of which contribute to the chronic effects of asthma. Understanding the mechanism behind the anti-inflammatory of effects of CO will help further the understanding of the range of effects of CO, and its potential for therapeutic use to treat airway inflammation.
"Network Visualization and Analysis of Biomedical Data"
Suresh K. Bhavnani, PhD Associate Professor of Biomedical Informatics
University of Texas, Medical Branch
University of Texas, Health Science Center in Houston
PI: Discovery and Innovation through Visual Analytics (DIVA Lab) http://skbhavnani.com/DIVA/
Abstract: The explosion of biomedical data has created new opportunities for the prevention, diagnosis, and treatment of diseases. However, the cognitive limitations of humans in comprehending large amounts of complex data poses a challenge for researchers. Dr. Bhavnani will discuss how he has used networks to address this challenge by helping researchers to visually explore complex multivariate relationships, develop hypotheses, and validate those hypotheses using graph-based and other statistical methods. The talk will abstract lessons learned from the analysis of genomic, proteomic, and phenomic data, and conclude by discussing the current strengths and limitations of networks.
"Protein Needs for Preserving Muscle Mass"
Madonna M. Mamerow, PhD, MCG, CPT
Division of Rehabilitation Sciences
School of Health Professions, UTMB
Thursday, March 3
1.104 Ewing Hall
Abstract: Sarcopenia, the loss of muscle mass, is an insidious condition contributing to decrements in strength, balance and coordination; greater incidence for falls; longer hospital stays and recovery times; loss of independence; and an overall reduced quality of life. Muscle loss negatively impacts the lives of most older adults, but it can be prevented. The recommended dietary allowance (RDA) for adult protein intake of 0.8 g/kg/d has generated much discussion among the scientific community as to whether this protein amount is adequate to maintain adult health status. This recommendation was established by the Institute of Medicine and is based on short-duration nitrogen balance studies with young adults. However, adults show lower efficiency for use of dietary protein and appear to require approximately 30 g of total protein per meal to fully stimulate muscle protein synthesis. This presentation will focus on protein needs for optimal meal response.
Competencies and Courses: Developing Integrated Curricular Plans for PMCH Graduate Programs
“Learning results from what the student does and thinks and only from what the student does and thinks. The teacher can advance learning only by influencing what the student does to learn.”
Herbert A. Simon
Nobel Laureate and University Professor (deceased) at Carnegie Mellon University
Laura Rudkin, PhD
Vice Chair for Education, PMCH
Thursday, March 10
1.104 Ewing Hall
Abstract: The Department of Preventive Medicine and Community Health administers three UTMB graduate programs—Public Health, Clinical Science, and Population Health Sciences—offering master’s and doctoral degrees. Curriculum planning in these programs is informed by competency frameworks developed by national organizations in public health and in clinical and translational sciences. Competency based curriculum plans shift the focus from what faculty members believe graduates need to know (teacher focused) to what students need to know and be able to do in professional settings (student or workplace focused). This approach to curriculum development is consistent with adult learning theories that emphasize that learning is not something done to students, but something done by students. This seminar will review basic principles from How Learning Works: 7 Research-Based Principles for Smart Teaching (SA Ambrose et al, 2010) and will apply these principles to developing an integrated, competency-based structure for the PMCH graduate programs.
"U.S. Life Tables by Race and Ethnicity: Data Challenges and Methodological Strategies"
Elizabeth Arias, Ph.D.
Mortality Statistics Branch
Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
Thursday, March 24
Abstract: The United States federal government has produced official life tables by race for over a century. However, the groups included have been limited to the racially classified white and black populations. The main reason for this limitation has been the lack of reliable vital registration, population and Medicare data for racial and ethnic minority populations. Recent research has identified and quantified these data limitations and led to the development of reliable methodological strategies to address these data quality limitations. In this presentation, I will discuss the data challenges that historically prevented the production of life tables for groups other than the racially classified white and black population as well as the methodological strategies employed to overcome them. I will present their application using as a primary example the recently published United States life tables by Hispanic origin. In addition, I will discuss the methodological strategies currently being developed in order to expand the US life table program further to include life tables for the Asian, American Indian, and Hispanic sub-group populations.
"Neighborhood Context and General Health among Non-Hispanic Whites, Non-Hispanic Blacks and
Hispanics of Mexican Origin: Results of the Texas City Stress and Health Study"
Quynh Do, MPH
Graduate Student, Population Health Sciences Program
Pre-Doctoral Fellow, Sealy Center on Aging
Thursday, March 31
Abstract: Neighborhoods have emerged as an important context for physical and psychological health. However, the impact of neighborhood perceptions on multidimensional health has been relatively unexplored. Negative perceptions concerning neighborhood environment can be a serious stressor of health and can be exacerbated when living near environmental hazards such as a petrochemical complex. Furthermore, little is known about how the relationship between neighborhood perceptions and health varies by race/ethnicity. Using data from the Texas City Stress and Health Study, this study examines the association between neighborhood perceptions and overall health among non-Hispanic whites, non-Hispanic blacks, and Hispanics of Mexican origin (n=2,500). Perceptions of neighborhood characteristics were measured across four dimensions of neighborhood context: perceived crime, social embeddedness, sense of community and neighborhood satisfaction. Overall health was measured by the SF-36, a multi-purpose, short-form health survey that is summed to calculate a score ranging from 0 to 100. The mean SF-36 was 63.6 ± 23.9 and the mean perceived neighborhood score was 21.4 ± 7.8. Results from hierarchical linear modeling showed that neighborhood perception is significantly and positively related to overall health. The results suggest overall health increased with more positive perception of neighborhood, especially in Hispanics of Mexican origin. Individual-level factors were statistically significant in predicting overall health including being female, age, Mexican origin, education, health insurance, low or middle income, former/current smoker, and underweight or obese. Thus, suggesting that the composition of the neighborhood (i.e., population) is more important than the neighborhood context itself in predicting physical and psychological health.
"The Vagina Monologue is a Dialogue from the Microbiome Perspective"
Graduate Student, Clinical Science Program
Thursday, April 7
Abstract: Beneficial vaginal microflora, including Lactobacillus spp, are essential components in maintenance of a healthy vaginal environment. During pathologic conditions such populations can decline in number being replaced by increasing levels of abnormal bacteria; this process is the basis for symptomatic and asymptomatic bacterial vaginosis (BV). BV has a prevalence of 29% in the US and has been associated with increased susceptibility to other life-threatening sexually transmitted infections and infertility. Clinically, Nugent scoring has been reported to be more sensitive than Amsel criteria for BV diagnosis but lacks the ability to accurately depict the species present in the vaginal microbiome. To address this concern and to evaluate alternatives to Nugent scoring, quantitative (q)PCR assays have been studied that have showed increases in both sensitivity and specificity over the Nugent method. We have adapted these qPCR assays to high-throughput using automation and have efficiently quantified genomic copies of common healthy and BV-associated bacteria (14 species) in vaginal fluid samples obtained from 30 women. These studies also provided kinetic snapshots of the dynamics of shifting microbiomes that contribute to urogenital health and disease in women. Importantly, the qPCR system effectively correlated with and enhanced the screening power for proper diagnosis of BV in asymptomatic woman.
“Traveling to High Altitude Destinations in South America: A survey on pre-travel preparation and acute mountain sickness in Cusco-Peru (3,310 m)”
Miguel M. Cabada, M.D.
Graduate Student, Clinical Science Program
Thursday, April 14
Abstract: The epidemiology of acute mountain sickness among regular tourists visiting high altitude destinations in South America is largely unknown. Preliminary data suggest that travelers to Cusco-Peru (3,310 m) are poorly prepared to avoid acute mountain sickness. A survey was design to study the epidemiology, pre-travel preparation, and impact of acute mountain sickness in travelers visiting Cusco. Foreign travelers, ≥ 18 years of age that stayed in Cusco ≤15 days were invited to participate. A convenience sample of 991 departing travelers was obtained at Cusco’s International Airport during June 2010. The Lake Louise Consensus score were used to assess the prevalence of acute mountain sickness and its severity. The median age of the participants was 32 years (IQR 25 – 49), 55.5% were female, 86.5% had higher education, 86.7% were traveling for tourism, and the main countries of origin were United States (47.7%) and England (8.1%). Most travelers (76.8%) flew from sea level to Cusco and 30.7% visited high altitude in the previous 2 months. Twenty nine percent received professional pre-travel advice about acute mountain sickness, 19% recalled receiving advice on acetazolamide use, and 16.4% used it. Frequent preventive measures were using coca leaf products (62.3%) and limiting physical activity (39.1%). Acute mountain sickness was reported by 47% of the participants and 16% reported severe disease. Twenty percent of travelers with acute mountain sickness altered their travel plans. In the multivariate analysis those older than 60 years, visiting high altitude in the recent past, visiting lower altitude cities during the same trip and using acetazolamide prophylaxis were less likely to have acute mountain sickness. Those using coca leaf products for prophylaxis and limiting their physical activity were more likely to have acute mountain sickness. This condition was common among the participants and had a significant impact on travel plans. Pre-travel preparation and healthcare seeking behavior were alarmingly inadequate. While acetazolamide prophylaxis was largely underutilized, coca leaf products were widely accepted but users were more likely to have acute mountain sickness.
"Update on Galveston County Health District Services & Role of Epidemiology"
Dana Wiltz-Beckham, DVM
Chief Epidemiologist/Veterinary Consultant
Galveston County Health District
There will not be a PMCH Seminar held at Ewing Hall. Students are required to attend the Healthy Health Policy Lecture Series.
The UTMB Office of Health Policy and Legislative Affairs, the Center to Eliminate Health Disparities, and
the Department of Preventive Medicine & Community Health Seminar Series
present the second lecture of the
2010 Healthy Health Policy Lunch & Lecture Series "Prospering in a Post Reform World"
Benjamin Isgur Director, Health Research Institute
Thursday, November 11, 2010
Shriner’s Hospital Auditorium, 7th Floor
Lunch Served beginning at 11:30 a.m.
Abstract: To prosper in the post-reform world, health executives will need to reassess current strategies and find ways to work together. The report illustrates the mega trends that each sector (provider, payer, and pharmaceutical and life sciences) will face as a result of health reform, the provisions in the law that are driving them, and recommendations on how organizations can turn these challenges into new opportunities. Most importantly, reform has opened the door for the industries to work together to achieve change. For example, with changes to their reimbursement structures, providers need to partner with payers and the pharmaceutical sector to share data, increase patient adherence and improve quality and outcomes.
Please plan to arrive by 11:30 a.m. to enjoy your lunch prior to entering the Shriner’s Auditorium
The PMCH Seminar scheduled for December 2, 2010 has been canceled.
Dr. Luxon is rescheduled to present on March 10, 2011.
December 16, 2010
12:00 – 1:00 pm
1.104 Ewing Hall
The PMCH GSO is hosting a Holiday Cookie Exchange.
Bring two dozen of your favorite homemade cookies and the recipe to share.
For those who are not bakers, bring a package of your favorite cookies to share.
If you would like to participate in the cookie
exchange, please RSVP to Allie Glaser.
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