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1
Beal, Ron. "Rulemaking Behind Closed Doors: Governor Abbott’s Secret Rulemaking. Worse Yet, All State Agencies Are Colluding with the Governor." SMU Law Review Forum 78, no. 1 (2025): 26–37. https://doi.org/10.25172/slrf.78.1.3.
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In 2019, the Texas Legislature granted the Governor new powers to review the rulemaking process for certain state agencies. Since then, the Governor has apparently extended this authority of review over the rulemaking process to more agencies than he was authorized to. Some journalists and scholars, including this Author, have attempted to access the proposals and comments submitted to the rulemaking process by the Governor’s Office—and yet the records are withheld by the Texas Attorney General under claimed exceptions to the Texas Public Information Act. Despite the Attorney General’s claims, this Author and others maintain that any records of these submissions to agencies’ rulemaking processes by the Governor should be publicly available as a matter of law. This Article lays out the recent history of the Governor’s “Secret Rulemaking Division,” and ultimately explains why, under the Texas Administrative Procedure Act, any and all comments, suggestions, or changes made by the Governor to state agencies’ rulemaking processes must be released as public information.
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Sames, William J., Eleanor O. Kirkscey, Raymond F. Dunton, Bethany G. Bolling, and Alexander L. Wild. "County-Level Records for Culex stigmatosoma and Culex thriambus in Texas." Journal of the American Mosquito Control Association 37, no. 1 (2021): 28–33. http://dx.doi.org/10.2987/20-6982.
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ABSTRACT Populations of Culex stigmatosoma and Cx. thriambus have been documented in the southwestern USA with a southward range extension to northern South America and Central America, respectively. Studies conducted in California indicate both species are potential vectors of West Nile virus. However, vector competence studies are lacking for other parts of the USA. During a multicounty regional surveillance study west of San Antonio, Texas, multiple errors were observed in the Texas distributional literature of these species. These errors involved incorrect distributional information in Texas and US publications. Evidence to correct these errant records was found upon further analysis of Texas literature and curated specimens. Therefore, the aims of this study were to present that evidence and then combine the corrected records with additional records from the Texas Department of State Health Services and from larval collections made during other Texas surveillance studies.
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Reynolds, Robert J., Emilie A. Becker, and Alan B. Shafer. "Causes of death and comparative mortality in Texas public mental health clients, 2006–2008." Mental Health Clinician 3, no. 1 (2013): 28–34. http://dx.doi.org/10.9740/mhc.n161217.
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Seriously mentally ill patients are known to have rates of mortality much greater than those of the general population. Prior research in Texas has shown inpatient Public Mental Health Clients (PMHCs) treated in in-patient settings were subject to greatly increased mortality, but little is known about the mortality of PMHCs in an outpatient setting in Texas. For this study outpatient service records for PMHCs treated in Texas were combined with death data from the Texas Department of State Health Services for 2006–2008. Frequencies of causes of death, age-adjusted death rates, standardized mortality ratios, and life expectancies were calculated from these data. The most frequent causes of death were external causes, followed by circulatory disease, and then neoplasms. Examination of the outcomes suggests that substance abuse plays a major role in the mortality of PMHCs in Texas in the form of drug overdoses, tobacco-related cancers, and alcoholic liver disease. Prevention efforts should therefore aim at integrating mental health services, substance abuse services, and careful medical and pharmacological monitoring, including medication monitoring to prevent suicides and accidental overdoses.
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Sames, William J., James G. Mann, Rosmarie Kelly, et al. "Distribution of Culex coronator in the USA." Journal of the American Mosquito Control Association 37, no. 1 (2021): 1–9. http://dx.doi.org/10.2987/21-6995.1.
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ABSTRACT In 1920, Culex coronator was reported from San Benito, Texas, and later in Arizona, New Mexico, and Oklahoma. In 2005, this species was reported to be spreading across the southeastern USA. Now reported in 14 states, it has been found as far north as northern Oklahoma; Memphis, TN; and Suffolk, VA. The public health significance of Cx. coronator is not firmly established, even though it has been implicated as a potential vector of several arboviral diseases. This study aims to document additional Cx. coronator county-level records, to provide information about its continued expansion across the southern USA, and to provide a short research update into its vector potential. Data acquired through multistate collaborations and author collections resulted in 146 new county records from Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, and Texas. No new county records were presented for Arizona, New Mexico, Tennessee, or Virginia, which had previously reported this species. With these new data, this species has been documented in 386 counties in 14 states of the continental USA.
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Metzger, Kristi, Hammad Akram, Bonnie Feldt, et al. "Epidemiologic Investigation of Injuries Associated With the 2013 Fertilizer Plant Explosion in West, Texas." Disaster Medicine and Public Health Preparedness 10, no. 4 (2016): 583–90. http://dx.doi.org/10.1017/dmp.2015.186.
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AbstractObjectiveOn April 17, 2013, a fire and subsequent explosion occurred at the West Fertilizer Company plant in West, Texas, and caused extensive damage to the adjacent neighborhood. This investigation described the fatal and nonfatal injuries caused by the explosion.MethodsPersons injured by the fertilizer plant explosion were identified through death certificates, medical examination reports, medical records, and survivor interviews. Data on patient characteristics, type of injury, and location of injury were collected.ResultsMedical record review indicated that 252 individuals sought medical care for nonfatal injuries directly related to the explosion immediately after the explosion. Fifteen patients died of injuries sustained by the blast. Almost one-quarter of patients were admitted for treatment of injuries. Injuries sustained in the explosion included abrasions/contusions, lacerations/penetrating trauma, traumatic brain injuries/concussions, tinnitus/hearing problems, eye injuries, and inhalational injuries. Patients located closer to the explosion were more likely to be admitted to the hospital for treatment of injuries than were those who were located further away.ConclusionExplosions of this magnitude are rare, but can inflict severe damage to a community and its residents. This investigation could be a useful planning resource for other communities, public health agencies, first responders, and medical facilities. (Disaster Med Public Health Preparedness. 2016;10:583–590)
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Sames, William J., Raymond F. Dunton, and Bethany G. Bolling. "A Checklist of the Mosquito Species in 13 Counties West of San Antonio, Texas." Journal of the American Mosquito Control Association 37, no. 3 (2021): 119–24. http://dx.doi.org/10.2987/21-6997.1.
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ABSTRACT The aim of this study was to consolidate mosquito information for 13 counties west of San Antonio, Bexar County, Texas, and to create a species checklist for future regional studies. The resulting checklist established a baseline for local mosquito-borne disease surveillance and can serve as a resource for public health officials. The 13 counties in this region were Bandera, Edwards, Kendall, Kerr, Kimble, Kinney, Maverick, Medina, Real, Sutton, Uvalde, Val Verde, and Zavala counties. To develop the checklist, county-level mosquito species data were extracted from 38 peer-reviewed publications and government documents, university reference collections, private collections, and the Texas Department of State Health Services' historical collection data. These data were combined with author field collections to create a comprehensive species list. Overall, 339 county-level records were documented through field studies with a total of 36 species representing 8 genera confirmed as being present in this region. An additional 14 species listed in historical surveillance records were not collected during this study.
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Kovalenko, Alina. "Natural Resource Booms, Human Capital, and Earnings: Evidence from Linked Education and Employment Records." American Economic Journal: Applied Economics 15, no. 2 (2023): 184–217. http://dx.doi.org/10.1257/app.20200762.
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Using administrative panel data on the universe of Texas public school students, I analyze how shocks to local economic conditions affect education and employment decisions. I find that high school students at the bottom of the academic ability distribution worked and earned more in response to the fracking boom and that these earnings gains persisted through ages 24–25 despite the fact that the same students also became less likely to attend classes and graduate from high school. My results suggest that the opportunity cost of education is large for these students. (JEL H75, I21, I26, J24, J31, R23)
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Wittmer, Matthew D. "Traces of the Mount Carmel Community: Documentation and Access." Nova Religio 13, no. 2 (2009): 95–113. http://dx.doi.org/10.1525/nr.2009.13.2.95.
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This article highlights some of the Waco Branch Davidian material holdings acquired by the Texas Collection at Baylor University and provides general information about the kinds of materials that have been acquired about this community and the siege and fire that occurred in 1993. I cite related materials in other collections to provide an overview of the kinds of records that are accessible, restricted, or inaccessible to the public regarding the David Koresh community and previous generations of religious communities who resided on the Mount Carmel property. To date, the collections at Baylor University and Texas State University––San Marcos are two of the most comprehensive efforts to preserve and provide access to a range of documentation about this community's history.
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Akpalu, Yao, Ibraheem Karaye, Julie Anderson, Osaro Mgbere, and Jennifer A. Horney. "Demographic Determinants of Influenza Vaccination and Infection, Brazos County, Texas, 2017." Infectious Diseases: Research and Treatment 12 (January 2019): 117863371986381. http://dx.doi.org/10.1177/1178633719863815.
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Background: Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity. Methods: Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers. Results: A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized. Discussion: Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.
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Gaebler, Johann D., Phoebe Barghouty, Sarah Vicol, Cheryl Phillips, and Sharad Goel. "Forgotten but not gone: A multi-state analysis of modern-day debt imprisonment." PLOS ONE 18, no. 9 (2023): e0290397. http://dx.doi.org/10.1371/journal.pone.0290397.
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In almost every state, courts can jail those who fail to pay fines, fees, and other court debts—even those resulting from traffic or other non-criminal violations. While debtors’ prisons for private debts have been widely illegal in the United States for more than 150 years, the effect of courts aggressively pursuing unpaid fines and fees is that many Americans are nevertheless jailed for unpaid debts. However, heterogeneous, incomplete, and siloed records have made it difficult to understand the scope of debt imprisonment practices. We culled data from millions of records collected through hundreds of public records requests to county jails to produce a first-of-its-kind dataset documenting imprisonment for court debts in three U.S. states. Using these data, we present novel order-of-magnitude estimates of the prevalence of debt imprisonment, finding that between 2005 and 2018, around 38,000 residents of Texas and around 8,000 residents of Wisconsin were jailed each year for failure to pay (FTP), with the median individual spending one day in jail in both Texas and Wisconsin. Drawing on additional data on FTP warrants from Oklahoma, we also find that unpaid fines and fees leading to debt imprisonment most commonly come from traffic offenses, for which a typical Oklahoma court debtor owes around $250, or $500 if a warrant was issued for their arrest.
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Sames, William J., Jeff Hamik, James G. Mann, Joshua D. Bast, and R. Jason Pitts. "Aedes japonicus japonicus in Nebraska and Texas." Journal of the American Mosquito Control Association 38, no. 2 (2022): 92–95. http://dx.doi.org/10.2987/21-7048.
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ABSTRACT Aedes japonicus japonicus continues to spread westward and in this study, its presence is documented in 8 counties in Nebraska and in Bowie County, TX. In 1998, Ae. japonicus was collected in Connecticut, New Jersey, and New York for the 1st records of this species in North America. Except for Louisiana, it has been reported from all states that border or are east of the Mississippi River. In Canada, it has been reported in Ontario and all eastern provinces. In the Pacific Northwest, it has been reported in Washington, Oregon, and British Columbia, and in the midwestern states that do not border the Mississippi River, Kansas, Oklahoma, and South Dakota are the only states to have reported its presence in peer-reviewed journals.
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Schraw, Jeremy M., Kara E. Rudolph, Charles J. Shumate, and Matthew O. Gribble. "Direct potable reuse and birth defects prevalence in Texas: An augmented synthetic control method analysis of data from a population-based birth defects registry." Environmental Epidemiology 8, no. 2 (2024): e300. http://dx.doi.org/10.1097/ee9.0000000000000300.
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Background: Direct potable reuse (DPR) involves adding purified wastewater that has not passed through an environmental buffer into a water distribution system. DPR may help address water shortages and is approved or is under consideration as a source of drinking water for several water-stressed population centers in the United States, however, there are no studies of health outcomes in populations who receive DPR drinking water. Our objective was to determine whether the introduction of DPR for certain public water systems in Texas was associated with changes in birth defect prevalence. Methods: We obtained data on maternal characteristics for all live births and birth defects cases regardless of pregnancy outcome in Texas from 2003 to 2017 from the Texas Birth Defects Registry and birth and fetal death records. The ridge augmented synthetic control method was used to model changes in birth defect prevalence (per 10,000 live births) following the adoption of DPR by four Texas counties in mid-2013, with county-level data on maternal age, percent women without a high school diploma, percent who identified as Hispanic/Latina or non-Hispanic/Latina Black, and rural-urban continuum code as covariates. Results: There were nonstatistically significant increases in prevalence of all birth defects collectively (average treatment effect in the treated = 53.6) and congenital heart disease (average treatment effect in the treated = 287.3) since June 2013. The estimated prevalence of neural tube defects was unchanged. Conclusions: We estimated nonstatistically significant increases in birth defect prevalence following the implementation of DPR in four West Texas counties. Further research is warranted to inform water policy decisions.
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Salwe, Kirtigandha, Shrawan Kumar, and Joyce Hood. "Nonfatal Occupational Injury Rates and Musculoskeletal Symptoms among Housekeeping Employees of a Hospital in Texas." Journal of Environmental and Public Health 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/382510.
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Objectives. To determine the prevalence of musculoskeletal disorders in hospital cleaners.Methods. Injury data on all hospital employees were extracted from occupational health records and compared. Additionally an interview-based modified Nordic Questionnaire (response rate 98.14%) was conducted.Results. The mean total injury rate for cleaners was 35.9 per 100 full-time equivalent (FTE), while that for other employees was 13.64 per 100 FTE. Slips/trips/falls and MMH contributed 4.39 and 2.37 per 100 FTE among cleaners and rest of the hospital employees, respectively. The most common type of injury was strain while the most common cause of injury was a striking object.Conclusion. The cleaners have higher injury rates and morbidity as compared to other employees of the hospital. The lower back was most commonly affected.
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Lalani, Karima, Christine Bakos-Block, Marylou Cardenas-Turanzas, Sarah Cohen, Bhanumathi Gopal, and Tiffany Champagne-Langabeer. "The Impact of COVID-19 on Opioid-Related Overdose Deaths in Texas." International Journal of Environmental Research and Public Health 19, no. 21 (2022): 13796. http://dx.doi.org/10.3390/ijerph192113796.
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Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner’s office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses were conducted to determine trends in the deaths, with a specific focus on the years 2019 to 2021. A total of 2660 deaths were included in the study and the mean (standard deviation, SD) age at death was 41.04 (13.60) years. Heroin and fentanyl were the most frequent opioids detected, present in 1153 (43.35%) and 1023 (38.46%) ORO deaths. We found that ORO deaths increased during the years 2019 to 2021 (p-value ≤ 0.001) when compared with 2015. Compared to the year 2019, ORO deaths increased for the years 2020 and 2021 (p-value ≤ 0.001). The geographic locations of ORO deaths were not associated with differences in the SVI. The COVID-19 pandemic had an impact on increasing ORO deaths in the metropolitan Houston area; however, identifying the determinants to guide targeted interventions in the areas of greatest need may require other factors, in addition to community-level social vulnerability parameters.
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Serrano, Jose, Harper R. Clouston, Jared Wiegand, et al. "1204. Assessing Perceptions and Efficacy of COVID-19 Case and Contact Investigations – Dallas County, Texas, 2020." Open Forum Infectious Diseases 8, Supplement_1 (2021): S693. http://dx.doi.org/10.1093/ofid/ofab466.1396.
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Abstract Background During 2020, a total of 193,318 cases of COVID-19 were reported in Dallas, with daily average case rates exceeding 50 per 100,000 for over 7 weeks. An adaptable survey functionality within a newly implemented COVID-19 surveillance system provided an opportunity to assess case knowledge and attitudes about isolation and contact tracing efforts. Methods COVID-19 illnesses were classified using the 2020 CSTE case definitions. Cases were interviewed and records reviewed for exposures and illness characteristics. Supplemental questionnaires assessing knowledge of public health recommendations were given to a convenience sample of 987 cases during the month of December 2020. Fishers exact and chi-square analyses were performed using SAS 9.4. Results Of the 987 respondents, 99% reported beginning isolation on or before receipt of test results, and 1% were not in isolation at the time of public health interview. Of cases reporting contacts, 92% had advised household members to quarantine prior to interview, and 91% did not want public health to call their household. Of cases reporting non-household close contacts, 75% had advised these contacts to quarantine prior to interview, and 91.3% did not want the health department to call these persons. Cases ≥ 65 years were less likely to have notified their own close contacts (OR: 0.2; 95% CI=0.1-0.8) of their test results, and more likely to prefer the health department to notify their household contacts of their positive result (OR: 4.1; 95% CI=1.3-12.5). Compared with White cases, Hispanic cases were less likely to be aware that their test was positive at the time of interview (OR: 0.3; 95% CI=0.1-0.7). Non-White cases were less likely to be aware of resources for food, rent and utility assistance prior to interview (OR: 0.25; 95% CI=0.1-0.7). All respondents perceived the public health interview to have been of some value to them, most often to answer their questions about retesting (51%) and duration of isolation (48%). Conclusion The aversion of a majority of COVID-19 cases for health department notification of their contacts is a significant deterrent to name-based contact tracing approaches. Acknowledgement of this limitation could better focus existing resources on the delivery of expedited notifications and information to contacts by proxy. Disclosures All Authors: No reported disclosures
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H, Ndetan, Menard RJ, Osuagwu CC, Singh KP, and Elueze E. "Obesity Prevalence and Potential Comorbidities among Rural Primary Care Patients in East Texas." Journal of Health Care and Research 1, no. 2 (2020): 43–49. http://dx.doi.org/10.36502/2020/hcr.6160.
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Objective: This study reports the prevalence of obesity among patients in a primary care clinic at a university teaching hospital in rural East Texas and explores potential disparities and comorbidities. Method: The study was a retrospective review of a deidentified, non-relinkable copy of the electronic health records for 6,955 patients who visited the Family Medicine Clinic of the University of Texas Health Science Center at Tyler North Campus between August 31, 2017, and August 1, 2018. Results: The prevalence of obesity was 43.2% with an increased likelihood of being obese among females compared to males (OR=1.49, 95%CI=1.35, 1.64), among blacks compared to whites (OR=1.24, 95%CI=1.11, 1.38), among patients 40-65 years old compared to those younger than 18 years (OR=8.83, 95%CI=7.31, 10.68) and a reduced likelihood among patients with public insurance/grants (OR=0.88, 95%CI=0.79, 0.98) and self-pay (OR=0.81, 95%CI=0.71, 0.93) compared to those with private insurance. Those who were obese were also more likely to report having hypertension (OR=2.59, 95%CI=2.35, 2.87), and diabetes (OR=3.26, 95%CI=2.85, 3.73). Conclusion: There is a high prevalence of obesity among rural primary care patients in East Texas especially among the female, minority black and 40-65 years age groups as well as among patients with diabetes and hypertension. With this facility being a teaching hospital, these findings suggest the need for increased emphasis in the training of medical Residents on the screening and management of obesity, metabolic syndrome, and associated comorbidities in these groups, with special focus on the root cause.
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Siddiqi, Ammar D., Maggie Britton, Tzuan A. Chen, et al. "Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment." International Journal of Environmental Research and Public Health 19, no. 15 (2022): 9647. http://dx.doi.org/10.3390/ijerph19159647.
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Tobacco use, and thus tobacco-related morbidity, is elevated amongst patients with behavioral health treatment needs. Consequently, it is important that centers providing health care to this group mandate providers’ use of tobacco screenings to inform the need for tobacco use disorder intervention. This study examined the prevalence of mandated tobacco screenings in 80 centers providing health care to Texans with behavioral health needs, examined key factors that could enhance screening conduct, and delineated providers’ perceived barriers to tobacco use intervention provision. The results indicated that 80% of surveyed centers mandated tobacco use screenings; those that did were significantly more likely than those that did not to have a hard stop for tobacco use status in health records and were marginally more likely to make training on tobacco screening available to providers. The most widespread barriers to tobacco use disorder care provision were relative perceived importance of competing diagnoses, lack of community resources to refer patients, perceived lack of time, lack of provider knowledge or confidence, and belief that patients do not comply with cessation treatment. Overall, the results suggest that there are opportunities for centers providing care to Texans with behavioral health needs to bolster their tobacco screening and intervention capacity to better address tobacco-related health disparities in this group. Health care centers can support their providers to intervene in tobacco use by mandating screenings, streamlining clinical workflows with hard stops in patient records, and educating providers about the importance of treating tobacco with brief evidence-based intervention strategies while providing accurate information about patients’ interest in quitting and providers’ potential impacts on a successful quit attempt.
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Malhan, Amit, Robert Pavur, Lou Pelton, and Ila Manuj. "Role of Electronic Healthcare Record Adoption in Enhancing the Relationship between Quality Measures and Hospital Financial Performance." American Business Review 25, no. 2 (2022): 515–32. http://dx.doi.org/10.37625/abr.25.2.515-532.
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Electronic Health Records (EHRs) are designed as a real-time digital record to streamline distinctive and valuable patient information across multiple stakeholders in the healthcare delivery channel. The stakeholders include hospitals, healthcare providers and patients, as well as a myriad of third-party providers (i.e., insurance companies, Medicare). Academicians, practitioners and public policy makers are grappling with uneven experiences and empirical findings regarding the relationship between technology-enabled information sharing and the ensuing quality of healthcare outcomes. The most significant government-mandated technology is the implementation and adoption of EHR. The present research examines EHR through the lens of Resource Advantage Theory –– to empirically assess how partial and comprehensive implementation levels of EHR adoption influence quality management and financial performance of hospitals. Based on archival data attained from 210 hospitals in the state of Texas, the results indicate positive relationships between EHR and the quality of care. While it is generally recognized that EHR and quality management affect a hospital’s performance, this research investigates the moderating effect that EHR has on quality management and a hospital’s performance. These findings provide hospital administrators, practitioners, and third-party payers with an integrative and parsimonious model to understand the impact of partial and comprehensive levels of EHR implementation on the relationship of healthcare quality and hospital performance.
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Wang, Yao, and Robert K. Kanter. "Disaster-Related Environmental Health Hazards: Former Lead Smelting Plants in the United States." Disaster Medicine and Public Health Preparedness 8, no. 1 (2014): 44–50. http://dx.doi.org/10.1017/dmp.2014.3.
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AbstractObjectiveNatural disasters exacerbate risks of hazardous environmental exposures and adverse health consequences. The present study determined the proportion of previously identified lead industrial sites in urban locations that are at high risk for dispersal of toxic chemicals by natural disasters.MethodsGeographic analysis from publicly available data identified former lead smelting plants that coincide with populated urban areas and with high-risk locations for natural disasters.ResultsFrom a total of 229 urban smelting sites, 66 (29%) were in relatively high-risk areas for natural disasters: flood (39), earthquake (29), tornado (3), and hurricane (2). States with urban sites at relatively high risk for natural disaster included California (15); Pennsylvania (14); New York (7); Missouri (6); Illinois (5); New Jersey (4); Kentucky (3); Florida, Oregon, and Ohio (2 each); and Indiana, Massachusetts, Rhode Island, Texas, Utah, and Washington (1 each). Incomplete historical records showed at least 10 smelting site locations were affected by natural disaster.ConclusionsForgotten environmental hazards may remain hazardous in any community. Uncertainty about risks in disasters causes disruptive public anxiety that increases difficulties in community responses and recovery. Our professional and public responsibility is to seek a better understanding of the risks of latent environmental hazards. (Disaster Med Public Health Preparedness. 2014;0:1–7)
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Lynn, Michael. "Did the COVID-19 Pandemic Dampen Americans’ Tipping for Food Services? Insights From Two Studies." Compensation & Benefits Review 53, no. 3 (2021): 130–43. http://dx.doi.org/10.1177/0886368721999135.
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The recent COVID-19 pandemic raises questions about consumer willingness to give tips during such times of hardship. Analyses of a Texas pizza delivery driver’s tip records and of nationwide Square payment data for quick- and full-service restaurants explored this issue by comparing tips during the pandemic with those before it. These data suggest that the pandemic increased the average tip-per-order given to a pizza delivery driver as well as the average tip percentage given for many transactions at quick- and full-service restaurants. They also suggest that the pandemic decreased the average tip percentage for face-to-face transactions at full-service restaurants but only by a modest 1 to 2 percentage points. The findings suggest that the tipping model remains a viable means of employee compensation even during periods of public health and economic crises if the nature of the services provided does not change substantially.
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Robbins, Richard. "Private Equity-Backed Steward Healthcare Files for Bankruptcy." Southwest Journal of Pulmonary, Critical Care & Sleep 26, no. 5 (2024): 71. http://dx.doi.org/10.13175/swjpccs021-24.
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No abstract available. Article truncated after 150 words. Arizona Attorney General Kris Mayes (1) has launched an investigation into what led to Dallas-based Steward Health Care filing for Chapter 11 bankruptcy protection on May 6. The health system also recently shared that it is $9 billion in debt and has plans to sell all 31 of its hospitals, four of which are in Arizona and have a proposed auction date of June 28, according to a May 10 news release from Ms. Mayes (1). Steward relied on backing from private equity investors to quickly acquire dozens of community hospitals, including facilities in Massachusetts, Texas, Florida, and Arizona. Steward has been the focus of a year-and-a-half-long CBS News investigation revealing how private equity investors have siphoned hundreds of millions of dollars from community hospitals with devastating public health consequences (2). Records reviewed by CBS News showed Steward hospitals around the country left a trail of unpaid bills, at times …
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Li, Chih-Ying, Emma Aguila, Paul Arthur, et al. "Assigning lifetime occupation domains for older Mexicans: MHAS-O*NET linkage protocol." Salud Pública de México 65, no. 5, sept-oct (2023): 425–33. http://dx.doi.org/10.21149/14635.
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Objective. We developed a MHAS (Mexican Health and Aging Study) and O*NET (Occupational Information Network) linkage to allow global researchers using MHAS data to assign lifetime occupation domains for older Mexicans. Materials and methods. Three bilingual raters independently matched 440 records with 132 unique occupation codes from the 2012 MHAS. We used a modified Delphi technique to reach agreements. To assess reliability, we compared the distribution of observations between the MHAS file and the MHAS-O*NET linked file across five job categories (upper white collar, lower white collar, upper blue collar, low blue collar, and agriculture/fishing/forestry). The Institutional Review Board at the University of Texas Medical Branch reviewed and approved the research (IRB # 21-0268). Results. Using the developed 1:1 MHAS-ONET linkage, consistency between MHAS and ONET was 97.4% across the five job categories. Conclusion. This MHAS-O*NET linkage will allow researchers to analyze the association between lifetime occupation and multiple dimensions of health, functionality, and retirement determinants for a low-middle income country with a large proportion of workers in the informal sector.
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Wada, Suzanne, Jared Wiegand, Mary Markarian, et al. "190. Epidemiology of COVID-19 Breakthrough Infections in Dallas County, Texas, 2021." Open Forum Infectious Diseases 8, Supplement_1 (2021): S115. http://dx.doi.org/10.1093/ofid/ofab466.190.
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Abstract Background From March 2020 through May 2021, Dallas County reported a total of 304,056 cases of COVID-19, including 4,073 deaths. During the month of December 2020, a post-holiday surge of cases led to peak daily average case rates of over 50 cases per 100,000. COVID-19 cases and deaths have since declined substantially following the rollout of COVID-19 vaccine delivery. As of June 8, 2021, about 1,831,588 Dallas County residents have received at least one COVID-19 vaccine dose and 910,067 are fully vaccinated. Recent county integration of immunization and case databases enabled identification and analysis of COVID-19 breakthrough infections. Methods A COVID-19 breakthrough infection was defined as a positive test (PCR or antigen) collected from an individual ≥ 14 days after receiving the full series of an FDA-authorized COVID-19 vaccine. Nationally, 10,262 vaccine breakthrough infections had been reported from 46 US states and territories, through April 2021. Vaccine breakthrough cases were reviewed and medical records abstracted to collect demographic information, clinical characteristics, and medical conditions. Data analysis was performed using R, version 4.0.2 (2020). Results Of the 700 vaccine breakthrough cases reported in Dallas County residents as of June 8, 2021, 304 (43%) were male and 396 (57%) female, with an average age of 53 years. The majority of the vaccine breakthrough cases were White (42%); 25% were Hispanic/Latino; and 20% were Black. Almost all breakthrough cases were confirmed with PCR testing, with 451 (64%) cases receiving the Pfizer vaccine. Of breakthrough cases, 49% were symptomatic; 52% (358) had underlying conditions including: tobacco use, obesity, or immunocompromised state; 68 (10%) were hospitalized; and 11 (1.6%) died. Whole genome sequencing was performed on 51 cases, with 14 (27.5%) variants identified, including: eight B.1.1.7, two B.1.429 and one P.1 variants. Conclusion Despite the high levels of vaccine efficacy documented in US vaccine trials, COVID-19 breakthrough infections, though currently uncommon, do occur and are important to investigate. Ongoing close public health surveillance of variants is needed to discern changes in patterns of vaccine efficacy and characteristics of populations at greatest risk of severe disease from COVID-19. Disclosures All Authors: No reported disclosures
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Testa, Alexander, Eresha Bluth, Latanya Monroe, et al. "Protocol for the Houston Hospital-based violence intervention program." PLOS One 20, no. 7 (2025): e0325569. https://doi.org/10.1371/journal.pone.0325569.
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Firearm violence is a leading cause of injury and mortality in the United States. Hospital-based violence intervention programs (HVIPs) are a promising public health strategy designed to reduce recurrent violence by engaging patients during hospitalization and connecting them to support services after discharge. This protocol describes the design and implementation of the Houston Hospital-Based Violence Intervention Program (Houston-HVIP), which will be evaluated by a randomized controlled trial conducted at a Level 1 trauma center in Houston, Texas. The study plans to enroll individuals aged 16–35 who present with gunshot wounds (GSW) at the Level 1 trauma center. Participants are randomized to either a treatment group receiving six months of intensive case management with direct referrals to social services or a control group receiving usual care, which involves indirect referral and limited case management. The primary outcome is a composite measure of an individual’s exposure to firearm violence via (a) self-report, (b) hospital admission records, and (c) mortality records. Secondary outcomes measured at the individual level assess violent reinjury, attitudes toward violence, post-traumatic stress, aggression, and self-rated health. Outcomes are assessed at baseline and 3-, 6-, 9-, and 12-months post-enrollment. The study will enroll 274 participants and include both quantitative and qualitative assessments to evaluate program impact and participant experience. This protocol aims to contribute to the design and implementation of HVIPs in large Level 1 trauma centers.
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Sabra, John P., José G. Cabañas, John Bedolla, et al. "Medical Support at a Large-scale Motorsports Mass-gathering Event: The Inaugural Formula One United States Grand Prix in Austin, Texas." Prehospital and Disaster Medicine 29, no. 4 (2014): 392–98. http://dx.doi.org/10.1017/s1049023x14000636.
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AbstractIntroductionFormula One returned to the United States on November 16-18, 2012, with the inaugural United States Grand Prix in Austin, Texas. Medical preparedness for motorsports events represents a unique challenge due to the potential for a high number of spectators seeking medical attention, and the possibility for a mass-casualty situation. Adequate preparation requires close collaboration across public safety agencies and hospital networks to minimize impact on Emergency Medical Services (EMS) resources.Hypothesis/ProblemTo report the details of preparation for an inaugural mass-gathering motorsports event, and to describe the details of the medical care rendered during the 3-day event.MethodsA retrospective analysis was completed utilizing postevent summaries, provided by the medical planning committee, by the Federation Internationale de L'Automobile (FIA), and Austin Travis County Emergency Medical Services (ATCEMS). Patient data were collected from standardized patient care records for descriptive analysis. Medical usage rates (MURs) are reported as a rate of patients per 10,000 (PPTT) participants.ResultsA total of 566 patients received medical care over the 3-day period with the on-site care rate of 95%. Overall, MUR was 21.3 PPTT attendees. Most patients had minor problems, and there were no driver injuries or deaths.ConclusionThis mass-gathering motorsport event had a moderate number of patients requiring medical attention. The preparedness plan was implemented successfully with minimal impact on EMS resources and local medical facilities. This medical preparedness plan may serve as a model to other cities preparing for an inaugural motorsports event.SabraJP, CabañasJG, BedollaJ, BorgmannS, HawleyJ, CravenK, BrownC, ZiebellC, OlveyS. Medical support at a large-scale motorsports mass-gathering event: the inaugural Formula One United States Grand Prix in Austin, Texas. Prehosp Disaster Med. 2014;29(4):1-7.
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Grudtsina, Ludmila Yu. "Digitalization of Justice in the United States: Case Management Electronic Case Files (CMECF) and Public Access to Court Electronic Records (PACER)." INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS 08, no. 04 (2025): 1551–56. https://doi.org/10.5281/zenodo.15166948.
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Relevance. The relevance of scientific research is that digitalization of justice is the process of introducing digital technologies into judicial systems in order to increase their efficiency, accessibility and transparency. In the United States, where the legal system is decentralized and has a variety of approaches in different states, digitalization is of particular importance. In this article, the author examines examples of digitalization of the judicial process and justice in some states of America (using the example of the states of New York, Texas, Florida, Arizona, Pennsylvania, Oregon, Montana, Minnesota, etc.). CM/ECF (Case Management/Electronic Case Files) and PACER (Public Access to Court Electronic Records) systems are key elements in the digitalization of the U.S. federal judiciary. They provide electronic management of court cases and provide public access to court documents. These systems play an important role in increasing the transparency, efficiency and accessibility of justice.Purpose of the article. The purpose of the article is to study the concept, content and nature of the digitalization of Justice in the United States. The author's goal was to achieve several results that together could answer the question: how to make the effect of digitalization of justice as large and useful as possible for citizens and the whole society as efficiently as possible, avoiding risks. It seems that this goal was achieved mainly through an analysis of the legislation of the US states, each of which has its own characteristics in the field of electronic filing of court documents, electronic justice and digitalization of court hearings, as well as online participation of parties in the court case.Methods. The leading method of researching the problem was the deductive method, which made it possible to study the legal nature of the digitalization of Justice in the United States. The article uses inductive method, method of system scientific analysis, comparative legal methods. The leading method underlying the solution to the problem is the inductive method, which consists in analyzing the legislation of the US states and identifying the general trend and vector of development of digitalization at the federal level.Results. The article concluded that the digitalization of judicial systems in the states of Pennsylvania, Oregon, Montana, Minnesota, Virginia, Georgia, Utah, Louisiana, Nevada, Illinois, Vermont, Missouri, Nebraska, etc. demonstrates a variety of approaches to electronic case management and digital justice. Each state implements unique technologies such as video conferencing, blockchain, artificial intelligence and automation. These innovations increase the efficiency, transparency and accessibility of justice, but their implementation comes with certain challenges, such as technical problems, ethical issues and high costs.
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Cullen, Karen W., Kathleen B. Watson, and Jayna M. Dave. "Middle-school students’ school lunch consumption does not meet the new Institute of Medicine's National School Lunch Program recommendations." Public Health Nutrition 14, no. 10 (2011): 1876–81. http://dx.doi.org/10.1017/s1368980011000656.
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AbstractObjectiveTo compare the school lunch consumption of Texas middle-school students with the 2009 Institute of Medicine's (IOM) school meal report recommendations. These new lunch menu patterns increase fruit to one serving and vegetables to two servings, with 50 % wholegrain food.DesignLunch food records were collected from middle-school students from four schools in south-east Texas in the spring of 2008, and entered into the Nutrition Data System for Research software. Average intake was calculated for those consuming meals according to the National School Lunch Program (NSLP; n 5414) and for those consuming lunch from other sources (n 239). The percentage of students selecting each food group was calculated.SettingMiddle schools in south-east Texas.SubjectsMiddle-school students in south-east Texas.ResultsStudents consuming NSLP meals reported consuming almost --><$>\tfrac{1}{2}<$><!-- serving of fruit, --><$>\tfrac{3}{4}<$><!-- serving of vegetables, 8 oz of milk and --><$>\tfrac{1}{3}<$><!-- serving of whole grains at lunch. Non-NSLP consumers reported almost no intake of fruit, vegetables or milk, and consumed --><$>\tfrac{1}{4}<$><!-- serving of whole grains at lunch. Among NSLP consumers, about 40 % selected and consumed a fruit serving. About two-thirds of students selected a vegetable, consuming about 67 %. Less than 4 % selected a dark green or orange vegetable.ConclusionsStudents’ lunch intake did not meet the new IOM recommendations. Few students selected dark green or orange vegetables, and only 40 % selected fruit. Whole grains consumption was low. Interventions with all stakeholders will be necessary to improve students’ food and beverage selections overall when school meal patterns are revised.
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Williams, Howard E., Scott W. Bowman, and Jordan Taylor Jung. "The Limitations of Government Databases for Analyzing Fatal Officer-Involved Shootings in the United States." Criminal Justice Policy Review 30, no. 2 (2016): 201–22. http://dx.doi.org/10.1177/0887403416650927.
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Federal government databases recording officer-involved shooting fatalities are incomplete and unreliable. Voluntary reporting to the Supplementary Homicide Report (SHR), the National Vital Statistics System (NVSS), and the Arrest-Related Death Program (ARDP) are subject to underreporting and classification errors. The same shortcomings apply to statewide reporting in California and Texas, the only states with mandatory reporting requirements. Content analysis of open source records identified officer-involved shooting fatalities that occurred in the United States from January 1, 2006, through December 31, 2015. Those data were compared with data from the government databases. Analysis revealed 7,869 officer-involved shooting fatalities, an average increase of 51.8 incidents per year. Fatalities increased from 594 in 2006 to 1,007 in 2015—an increase of 69.5% in 10 years. Government data sources reported a low of 46.0% of incidents to a high of 75.3%, depending on the reporting year. Open source research reveals 30% to 45% more cases than official federal or state databases and can reveal much more data about other critical questions. The history of federal program efforts suggests it is unlikely that government recording of data on officer-involved shooting fatalities will improve. Government reporting programs have produced decreasingly effective results. Current web-based data collection efforts suffer from many of the same limitations exhibited in the federal programs. One promising option for improved data collection includes funding an independent party, such as a university, to collect data from open sources and supplement that data with public records requests and the currently collected official government data.
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Rao, Sanjana, Kiran Ali, Jeff Dennis, Gilbert Berdine, Victor Test, and Kenneth Nugent. "Analysis of Glucose Levels in Patients Hospitalized With COVID-19 During the First Phase of This Pandemic in West Texas." Journal of Primary Care & Community Health 11 (January 2020): 215013272095853. http://dx.doi.org/10.1177/2150132720958533.
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Background: Patients with hyperglycemia during hospitalization, especially during ICU hospitalizations, often have worse outcomes, even if they do not have a premorbid diagnosis of diabetes. High glucose levels can provide insight into the underlying pathogenesis of a disease and can contribute to tissue injury. Some patients with COVID-19 have hyperglycemia during hospitalizations. Methods: The Infectious Disease and Control office at University Medical Center in Lubbock, Texas, provided a list of patients with a COVID-19 infection hospitalized between March 1 and May 15, 2020. The medical records were reviewed to collect information on age, gender, history of diabetes, and glucose levels on admission and through the first 7 days of hospitalization. Results: This study included 63 patients with a mean age of 62.1 ± 14.1 years. Thirty-five patients (55.6%) were males. The in-hospital mortality rate was 30.2%. The mean admission glucose level was 129.4 ± 57.1 mg/dL in patients who survived (N = 47) and 189.6 ± 112.2 mg/dL in patients who died during hospitalization (N = 16, P = .007). An admission glucose greater than 180 mg/dL predicted mortality in a model adjusted for a diabetes, age, and male gender. The mean differences between the maximum and minimum glucose levels calculated over the first 7 days of hospitalization were 112.93 ± 115.4 (N = 47) in patients who survived and were 240.5 ± 97.7 (N = 15) in patients who died during hospitalization ( P = .0003). A difference between the maximum and minimum glucose level greater than 105 mg/dL was associated with increased mortality. Conclusions: Patients who died during hospitalization for COVID-19 had higher admission glucose levels than patients who survived. Larger differences between maximum and minimum glucose levels during the first 7 days of hospitalization were associated with increased mortality. These results suggest that high glucose levels identify patients at increased risk for mortality and warrant more study.
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Omo-Okhuasuyi, Anita, Yu-Fang Jin, Mahmoud ElHefnawi, Yidong Chen, and Mario Flores. "Multimodal Identification of Molecular Factors Linked to Severe Diabetic Foot Ulcers Using Artificial Intelligence." International Journal of Molecular Sciences 25, no. 19 (2024): 10686. http://dx.doi.org/10.3390/ijms251910686.
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Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), which often lead to hospitalization and non-traumatic amputations in the United States. Diabetes prevalence estimates in South Texas exceed the national estimate and the number of diagnosed cases is higher among Hispanic adults compared to their non-Hispanic white counterparts. San Antonio, a predominantly Hispanic city, reports significantly higher annual rates of diabetic amputations compared to Texas. The late identification of severe foot ulcers minimizes the likelihood of reducing amputation risk. The aim of this study was to identify molecular factors related to the severity of DFUs by leveraging a multimodal approach. We first utilized electronic health records (EHRs) from two large demographic groups, encompassing thousands of patients, to identify blood tests such as cholesterol, blood sugar, and specific protein tests that are significantly associated with severe DFUs. Next, we translated the protein components from these blood tests into their ribonucleic acid (RNA) counterparts and analyzed them using public bulk and single-cell RNA sequencing datasets. Using these data, we applied a machine learning pipeline to uncover cell-type-specific and molecular factors associated with varying degrees of DFU severity. Our results showed that several blood test results, such as the Albumin/Creatinine Ratio (ACR) and cholesterol and coagulation tissue factor levels, correlated with DFU severity across key demographic groups. These tests exhibited varying degrees of significance based on demographic differences. Using bulk RNA-Sequenced (RNA-Seq) data, we found that apolipoprotein E (APOE) protein, a component of lipoproteins that are responsible for cholesterol transport and metabolism, is linked to DFU severity. Furthermore, the single-cell RNA-Seq (scRNA-seq) analysis revealed a cluster of cells identified as keratinocytes that showed overexpression of APOE in severe DFU cases. Overall, this study demonstrates how integrating extensive EHRs data with single-cell transcriptomics can refine the search for molecular markers and identify cell-type-specific and molecular factors associated with DFU severity while considering key demographic differences.
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Yellman, Merissa A., Cora Peterson, Mary A. McCoy, et al. "Preventing deaths and injuries from house fires: a cost–benefit analysis of a community-based smoke alarm installation programme." Injury Prevention 24, no. 1 (2017): 12–18. http://dx.doi.org/10.1136/injuryprev-2016-042247.
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BackgroundOperation Installation (OI), a community-based smoke alarm installation programme in Dallas, Texas, targets houses in high-risk urban census tracts. Residents of houses that received OI installation (or programme houses) had 68% fewer medically treated house fire injuries (non-fatal and fatal) compared with residents of non-programme houses over an average of 5.2 years of follow-up during an effectiveness evaluation conducted from 2001 to 2011.ObjectiveTo estimate the cost–benefit of OI.MethodsA mathematical model incorporated programme cost and effectiveness data as directly observed in OI. The estimated cost per smoke alarm installed was based on a retrospective analysis of OI expenditures from administrative records, 2006–2011. Injury incidence assumptions for a population that had the OI programme compared with the same population without the OI programme was based on the previous OI effectiveness study, 2001–2011. Unit costs for medical care and lost productivity associated with fire injuries were from a national public database.ResultsFrom a combined payers' perspective limited to direct programme and medical costs, the estimated incremental cost per fire injury averted through the OI installation programme was $128,800 (2013 US$). When a conservative estimate of lost productivity among victims was included, the incremental cost per fire injury averted was negative, suggesting long-term cost savings from the programme. The OI programme from 2001 to 2011 resulted in an estimated net savings of $3.8 million, or a $3.21 return on investment for every dollar spent on the programme using a societal cost perspective.ConclusionsCommunity smoke alarm installation programmes could be cost-beneficial in high-fire-risk neighbourhoods.
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Brady, Kathleen A., Deborah S. Storm, Azita Naghdi, Toni Frederick, Jessica Fridge, and Mary Jo Hoyt. "Perinatal HIV Exposure Surveillance and Reporting in the United States, 2014." Public Health Reports 132, no. 1 (2016): 76–84. http://dx.doi.org/10.1177/0033354916681477.
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Objective: We sought to describe the current status of perinatal HIV exposure surveillance (PHES) activities and regulations in the United States and to make recommendations to strengthen PHES. Methods: In 2014, we sent an online survey to health departments in the 50 states, District of Columbia, Puerto Rico, Virgin Islands, and 6 cities and counties (Chicago, Illinois; Houston, Texas; Los Angeles, California; New York, New York; Philadelphia, Pennsylvania; and San Francisco, California). We analyzed responses from 56 of the 59 (95%) jurisdictions. Results: Thirty-three of 56 jurisdictions (59%) reported conducting PHES and following infants to determine their infection status. Of the 33 jurisdictions performing PHES, 28 (85%) linked maternal and infant data, but only 12 (36%) determined the HIV care status of postpartum women. Themes of respondents’ recommendations for strengthening PHES centered on updating laws and regulations to support PHES, reporting all HIV test results and linking vital records with PHES data to identify and follow HIV-exposed infants, communicating with health care providers to improve reporting, training staff, and getting help from experienced jurisdictions to implement PHES. Conclusions: Our findings indicate that data on perinatal exposure collected through the current system are inadequate to comprehensively monitor and prevent perinatal HIV exposure and transmission. Comprehensive PHES data collection and reporting are needed to sustain the progress that has been made toward lowering perinatal HIV transmission rates. We propose that minimum standards be established for perinatal HIV exposure reporting to improve the completeness, quality, and efficiency of PHES in the United States.
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Haq, Arooba A., Lorraine R. Reitzel, Tzuan A. Chen, et al. "“UHAND”—A National Cancer Institute Funded Partnership to Advance Cancer Health Equity through Scholar Training." International Journal of Environmental Research and Public Health 18, no. 10 (2021): 5054. http://dx.doi.org/10.3390/ijerph18105054.
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Black and Hispanic adults are disproportionately affected by cancer incidence and mortality, and experience disparities in cancer relative to their White counterparts in the US. These groups, including women, are underrepresented among scientists in the fields of cancer, cancer disparities, and cancer care. The “UHAND” Program is a partnership between institutions (University of Houston and The University of Texas MD Anderson Cancer Center) aiming to build the capacity of underrepresented and racial/ethnic minority student “scholars” to conduct research on eliminating cancer inequities by reducing social and physical risk factors among at-risk groups. Here, we examine the outcomes of the UHAND Program’s first scholar cohort (n = 1 postdoctoral fellow, n = 3 doctoral scholars, n = 6 undergraduate scholars). Data collection included baseline, mid-program, and exit surveys; program records; and monthly scholar achievement queries. From baseline to exit, scholars significantly increased their research self-efficacy (p = 0.0293). Scholars largely met goals for academic products, achieving a combined total of 65 peer-reviewed presentations and nine empirical publications. Eight scholars completed the 2-year program; one undergraduate scholar received her degree early and the postdoctoral fellow accepted a tenure-track position at another university following one year of training. Scholars highly rated UHAND’s programming and their mentors’ competencies in training scholars for research careers. Additionally, we discuss lessons learned that may inform future training programs.
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Hackl, Caitlin M., Wei-Chen Lee, Hanaa S. Sallam, Hani Jneid, Kendall M. Campbell, and Hani Serag. "Racial Disparities in Selected Complications and Comorbidities among People with Type 2 Diabetes." Healthcare 12, no. 8 (2024): 846. http://dx.doi.org/10.3390/healthcare12080846.
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Type 2 diabetes (T2D) is a growing public health concern, disproportionately impacting racial and ethnic minorities. Assessing disparities is the first step towards achieving the translation goal to reduce disparities in diabetes outcomes, according to the Centers for Disease Control and Prevention (CDC)’s Division of Diabetes. We analyzed the data of patients (18+ years) diagnosed with T2D between 1 January 2012 and 31 March 2017, using the electronic health records of the University of Texas Medical Branch at Galveston. We compared the crude rate and age-standardized rate (using direct method) of selected micro- and macrovascular complication rates, associated obesity, and insulin dependence among racial and ethnic groups. Our sample included 20,680 patients who made 394,106 visits (9922 non-Hispanic White patients, 4698 non-Hispanic Black patients, and 6060 Hispanic patients). Our results suggest a higher risk of acquiring macrovascular (hypertension, ischemic disease, and stroke) and microvascular (renal, ophthalmic, and neurological) complications in Black patients compared to non-Hispanic White and Hispanic patients. The rates of stage I or II obesity were higher in Black patients compared with White and Hispanic patients. The rates of insulin use rather than oral hypoglycemics were also higher in Black patients than White and Hispanic patients. The disparities in terms of the higher susceptibility to complications among Black patients are possibly linked to the socioeconomic disadvantages of this population, leading to poorer management. Prevention strategies are warranted to reduce the incidence of T2D complications in racial minorities.
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Shriver, Sharon, Salim Semy, Zach Lister, Waddah Arafat, and Mark Fleury. "Blue-button: A tool for institution-agnostic, EHR-integrated regional clinical trial matching." JCO Oncology Practice 20, no. 10_suppl (2024): 65. http://dx.doi.org/10.1200/op.2024.20.10_suppl.65.
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65 Background: Research indicates that most people with cancer are willing to enroll in clinical trials when offered the chance, but only 7% actually participate in cancer treatment trials. Barriers to screening and enrollment include time and effort for providers to screen patients for trials, and lack of awareness of available regional trials. Stakeholders recommended creation of free, automated screening tools and processes integrated into provider workflows, directly interfacing with site electronic health records (EHRs), that would search for regional trial eligibility. The need for such tools was independently identified in a large national survey of oncology providers. Methods: The Blue-button tool was developed to automatically identify relevant, regional clinical trials. A collaboration between ACS CAN and MITRE, a not-for-profit organization working in the public interest, created the tool’s functionality. Clinical workflow and research protocol were developed in collaboration with University of Texas Southwestern Simmons Comprehensive Cancer Center. This SMART-on-FHIR application works within existing EHR systems by automatically extracting and sending limited, deidentified patient data elements to third-party trial matching services via the FHIR mCODE standard, a core set of non-proprietary, open-source structured data elements that establishes minimum standards for the structure and content of oncology data in health records. Potential trial matches within a specified radius of the practice are returned in a standard format using the FHIR Research Study resource. Results: Blue-button extracts limited patient data from EHR and provides it in an interface allowing users to update data before sending to trial matching services. Only non-identifiable information is sent to the external clinical trial matching services, which then return prescreen trial matches for manual review to confirm patient eligibility. Thus, with a few clicks in a medical record, the tool quickly identifies comprehensive trial availability within a specified distance of the patient’s location. When used by providers, Blue-button reduces the manual burden that often prevents consideration of clinical trials and identifies regional opportunities beyond the treating institution. Conclusions: Successful feasibility testing demonstrated the effectiveness of automated regional trial screening as a model. We have launched a clinical trial at two sites to assess the effectiveness of the Blue-button tool with patients in healthcare settings. We expect patient enrollment to continue through part or all of 2025. This trial of the Blue-button tool will provide additional information on provider accessibility and uptake and will demonstrate whether EHR-integrated regional trial screening leads to increased opportunities and enrollment in cancer clinical trials. Clinical trial information: NCT05885880 .
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Rojas-Moreno, Christian A., Daniel Spiegel, Venkata Yalamanchili, et al. "Catheter-Related Bloodstream Infections in Patients on Emergent Hemodialysis." Infection Control & Hospital Epidemiology 37, no. 3 (2015): 301–5. http://dx.doi.org/10.1017/ice.2015.293.
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OBJECTIVEThis study had 2 objectives: (1) to describe the epidemiology of catheter-related bloodstream infections (CRBSI) in patients with end-stage renal disease (ESRD) who have no access to scheduled dialysis and (2) to evaluate whether a positive culture of the heparin-lock solution is associated with subsequent development of bacteremia.DESIGNRetrospective observational cohort design for objective 1; and prospective cohort design for objective 2.SETTING AND PARTICIPANTSThe study was conducted in a 770-bed public academic tertiary hospital in Dallas, Texas. The participants were patients with ESRD undergoing scheduled or emergent hemodialysis.METHODSWe reviewed the records of 147 patients who received hemodialysis between January 2011 and May 2011 and evaluated the rate of CRBSI in the previous 5 years. For the prospective study, we cultured the catheter heparin-lock solution in 62 consecutive patients between June 2012 and August 2012 and evaluated the incidence of CRBSI at 6 months.RESULTSOf the 147 patients on emergent hemodialysis, 125 had a tunneled catheter, with a CRBSI rate of 2.61 per 1,000 catheter days. The predominant organisms were Gram-negative rods (GNR). In the prospective study, we found that the dialysis catheter was colonized more frequently in patients on emergent hemodialysis than in those on scheduled hemodialysis. Colonization with GNR or Staphylococcus aureus was associated with subsequent CRBSI at 6 months follow-up.CONCLUSIONSPatients undergoing emergent hemodialysis via tunneled catheter are predisposed to Gram-negative CRBSI. Culturing the heparin-lock solution may predict subsequent episodes of CRBSI if it shows colonization with GNR or Staphylococcus aureus. Prevention approaches in this population need to be studied further.Infect. Control Hosp. Epidemiol. 2016;37(3):301–305
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Cope, Jennifer R., Mia Mattioli, Vaidehi Shah, Rebecca Greeley, Michele Hlavsa, and Vincent Hill. "1626. A Primary Amebic Meningoencephalitis Case Associated with Surfing in an Inland Surf Park." Open Forum Infectious Diseases 6, Supplement_2 (2019): S593. http://dx.doi.org/10.1093/ofid/ofz360.1490.
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Abstract Background Naegleria fowleri is a thermophilic ameba that is found in freshwater and causes primary amebic meningoencephalitis (PAM; 0–8 infections per year in the United States) when it enters the nose and migrates to the brain. Patient exposure to water containing the ameba typically occurs in warm freshwater lakes and ponds during recreational water activities. In September 2018, a 29-year-old man died of PAM after visiting a Texas inland surf park. Methods To determine water exposures, we reviewed medical records and conducted interviews with family and individuals who had traveled with the patient. To further investigate the inland surf park as a possible exposure source, we visited the facility and collected water, biofilm, and sediment samples from the surf park and other venues (water slides, lazy river, and cable park) within the facility. We assessed water sources and treatment practices, performed water quality tests, and tested for the presence of N. fowleri by culture and real-time PCR. Results Interviews revealed that the case-patient’s most probable water exposure in the 10 days before becoming ill occurred while surfing in an inland freshwater surf park where he fell off the surfboard into the water multiple times. The on-site investigation of the facility revealed a practice of manual chlorine treatment with monitoring, but no water filtering or record keeping to document water quality. Surf park water temperature was warm (25°C) and chlorine residual was negligible. N. fowleri was detected in 1 water and 1 sediment sample collected at the cable park venue, and viable thermophilic amebae were detected in all samples collected from the surf park, water slide, and cable park venues, as well from the sediment in the open-air groundwater reservoir feeding the venues. Conclusion This investigation documents a novel exposure in an inland surf park as the likely exposure causing PAM. Conditions in the surf park were conducive to amebic growth. Novel types of recreational water venues that do not meet traditional definitions of swimming pools, such as this surf park, might not meet the water quality standards for pools or similar treated venues. Clinicians and public health officials should remain vigilant for nontraditional exposures to water. Disclosures All authors: No reported disclosures.
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O’Neill, Liam, and Neale R. Chumbler. "Examining the risk of delirium in patients hospitalized with COVID-19: Insights from the homeless population." PLOS ONE 20, no. 1 (2025): e0313242. https://doi.org/10.1371/journal.pone.0313242.
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For patients hospitalized with COVID-19, delirium is a serious and under-recognized complication, and people experiencing homelessness (PEH) may be at greater risk. This retrospective cohort study compared delirium-associated risk factors and clinical outcomes between PEH and non-PEH. This study used patient records from 154 hospitals discharged from 2020–2021 from the Texas Inpatient Public Use Data file. Study subjects (n = 878) were patients, aged 18–69 years, who were hospitalized with COVID-19 and were identified as homeless. The baseline group included (n = 176,518) patients with COVID-19 aged 18–69 years who were not homeless. Logistic regression models were used to identify risk factors for delirium. Relevant risk factors included chronic comorbidities, substance use disorders, and traumatic brain injury (TBI). Seven of the delirium-associated risk factors were more prevalent among PEH compared to baseline. PEH had higher rates of TBI, alcohol, cannabis, and opioid use disorders. PEH had significantly higher rates of delirium (10.6% vs. 8.1%; P<0.01). However, PEH had fewer respiratory complications, including pneumonia (48.5% vs. 81.9%; P<0.001) and respiratory failure (28.7% vs. 61.9%; P<0.001), and lower in-hospital mortality (3.3% vs. 9.5%; P<0.001). The anti-viral Remdesivir had a protective effect against delirium (AOR = 0.63; CI: 0.60, 0.66). Mean hospital length of stay (LOS) was more than twice as long for delirious patients compared with non-delirious patients (18.4 days vs. 7.7 days; P<0.001). Delirium greatly increased the risk of in-hospital mortality (AOR = 3.8; CI: 3.6, 4.0). For PEH (n = 29) who died from COVID-19, delirium was present in more than half (52%) of cases. Hospitals should screen PEH for delirium and adopt nursing protocols to prevent delirium and reduce its severity.
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Novotná, Eva. "Full texts in the Czech geographical bibliography database." Geoinformatics FCE CTU 13 (December 21, 2014): 19–24. http://dx.doi.org/10.14311/gi.13.2.
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Open access to the documents is one of the basic requirements of databases users. Czech Geographical Bibliography On-line provides access to 185,000 bibliographical records of Bohemical geographic and cartographic documents and to more than 30,000 full texts and objects. The access is provided through a connection from the permanent storage, the Digital University Repository or a URL address of the bibliographical record. The works in public domain can directly become accessible or it is necessary to conclude licence agreement with authors, their heirs or with the editors of periodicals. Full texts of 14 titles of professional periodicals, university thesis, employees´ monographs or anthologies and on-line publications are available. Digitised maps have been connected to the database since 2012. 5,500 of them are accessible from the database since the beginning of 2014. The database is an important source both for professionals and general public interested in geography and cartography.
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HARVEY, A. D. "TEXTS BY TWENTIETH-CENTURY NOVELISTS IN THE PUBLIC RECORD OFFICE." Notes and Queries 46, no. 4 (1999): 493–96. http://dx.doi.org/10.1093/nq/46-4-493.
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HARVEY, A. D. "TEXTS BY TWENTIETH-CENTURY NOVELISTS IN THE PUBLIC RECORD OFFICE." Notes and Queries 46, no. 4 (1999): 493–96. http://dx.doi.org/10.1093/nq/46.4.493.
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Walby, Kevin, and Mike Larsen. "Getting at the Live Archive: On Access to Information Research in Canada." Canadian journal of law and society 26, no. 3 (2011): 623–33. http://dx.doi.org/10.3138/cjls.26.3.623.
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Most of the draft documents, memoranda, communications, and other textual materials amassed by government agencies do not become public record unless efforts are taken to obtain their release. One mechanism for doing so is “access to information” (ATI) or “freedom of information” (FOI) law. Individuals and organizations in Canada have a quasi-constitutional right to request information from federal, provincial, and municipal levels of government. A layer of bureaucracy has been created to handle these requests and manage the disclosure of information, with many organizations having special divisions, coordinators, and associated personnel for this purpose. The vast majority of public organizations are subject to the federal Access to Information Act (ATIA) or the provincial and municipal equivalents.We have been using ATI requests to get at spectrum of internal government texts. At one end of the spectrum, we are seeking what Gary Marx calls “dirty data” produced by policing, national security, and intelligence agencies. Dirty data represent “information which [are] kept secret and whose revelation would be discrediting or costly in terms of various types of sanctioning.” This material can take the form of the quintessential “smoking gun” document, or, more often, a seemingly innocuous trail of records that, upon analysis, can be illuminating. Dirty data are often kept from the public record. At the other end of the disclosure spectrum are those front-stage texts that represent “official discourse,” which are carefully crafted and released to the public according to government messaging campaigns.
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Perez, Bianca J., Averi Harp Segrest, Sofia R. Campos, Russell L. Minton, and Romi L. Burks. "First record of Japanese Mystery Snail Cipangopaludina japonica (von Martens, 1861) in Texas." Check List 12, no. 5 (2016): 1973. http://dx.doi.org/10.15560/12.5.1973.
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Two Cipangopaludina snails were discovered in Harris County, Texas, USA, during routine fieldwork in October 2015. Dissection yielded one male and one female containing 52 offspring in her brood pouch. Phylogenetic analysis of the cytochrome c oxidase subunit I (COI) gene confirmed both individuals to be Cipangopaludina japonica (von Martens, 1861). This is the first distribution record of C. japonica in Texas. Non-native invasive snails, such as C. japonica, compete with native species and may serve as reservoirs for parasites, prompting the need for increased diligence in monitoring public waterways.
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Eibedingil, Iyasu G., Thomas E. Gill, R. Scott Van Pelt, and Daniel Q. Tong. "Comparison of Aerosol Optical Depth from MODIS Product Collection 6.1 and AERONET in the Western United States." Remote Sensing 13, no. 12 (2021): 2316. http://dx.doi.org/10.3390/rs13122316.
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Recent observations reveal that dust storms are increasing in the western USA, posing imminent risks to public health, safety, and the economy. Much of the observational evidence has been obtained from ground-based platforms and the visual interpretation of satellite imagery from limited regions. Comprehensive satellite-based observations of long-term aerosol records are still lacking. In an effort to develop such a satellite aerosol dataset, we compared and evaluated the Aerosol Optical Depth (AOD) from Deep Blue (DB) and Dark Target (DT) product collection 6.1 with the Aerosol Robotic Network (AERONET) program in the western USA. We examined the seasonal and monthly average number of Moderate Resolution Imaging Spectroradiometer (MODIS) Aqua DB AOD retrievals per 0.1∘×0.1∘ from January 2003 to December 2017 across the region’s different topographic, climatic, and land cover conditions. The number of retrievals in the southwest United States was on average greater than 37 days per 90 days for all seasons except summer. Springtime saw the highest number of AOD retrievals across the southwest, consistent with the peak season for synoptic-scale dust events. The majority of Arizona, New Mexico, and western Texas showed the lowest number of retrievals during the monsoon season. The majority of collocating domains of AOD from the Aqua sensor showed a better correlation with AERONET AOD than AOD from Terra, and the correlation coefficients exhibited large regional variability across the study area. The correlation coefficient between the couplings Aqua DB AOD-AERONET AOD and Terra DB AOD-AERONET AOD ranges from 0.1 to 0.94 and 0.001 to 0.94, respectively. In the majority of the sites that exhibited less than a 0.6 correlation coefficient and few matched data points at the nearest single pixel, the correlations gradually improved when the spatial domain increased to a 50 km × 50 km box averaging domain. In general, the majority of the stations revealed significant correlation between MODIS and AERONET AOD at all spatiotemporal aggregating domains, although MODIS generally overestimated AOD compared to AERONET. However, the correlation coefficient in the southwest United States was the lowest and in stations from a higher latitude was the highest. The difference in the brightness of the land surface and the latitudinal differences in the aerosol inputs from the forest fires and solar zenith angles are some of the factors that manifested the latitudinal correlation differences.
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Katherine. Theoktisto, Mary, Delvina Ford, Omar Khan, Kelly R. Reveles, and Jose Cadena. "1379. Comparison of Inpatient Tuberculosis Screening Methods and Their Effect on Patient Duration in Airborne Isolation." Open Forum Infectious Diseases 6, Supplement_2 (2019): S501. http://dx.doi.org/10.1093/ofid/ofz360.1243.
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Abstract Background Tuberculosis (TB) remains a significant public health concern, and exposure in healthcare settings is prevalent. Current guidelines recommend testing for TB by acid-fast bacilli (AFB) smear microscopy with 3 sputum samples and/or using nucleic acid amplification test (NAAT), and mycobacterium culture. The purpose of this project is to compare how different TB diagnostic tests affect the duration of stay in respiratory isolation. Methods This study was conducted at the Veteran Affairs South Texas hospital, which includes a total of 437 beds. Data were collected retrospectively from medical records. Eligibility included patients admitted to the hospital and placed in airborne isolation for TB screening and diagnosis, had 3 sputum samples collected 8 hours apart and/or had 2 PCR MTB/RIF. Patients were excluded if they had TB or were not undergoing evaluation for TB. Three time periods analyzed included, 3 AFB sputum samples analyzed in-house from December 2012 to January 2014 (Group A), 3 AFB sputum samples analyzed at outside facility during 2013 to 2014 as well as 2 months in 2012 (Group B), and 2 MTB PCR/RIF in house during 2017 and 2018 (Group C). Duration of isolation was compared between groups using the Kruskal–Wallis test. A total number of 815 patients were screened, leaving 105 patients for analysis after exclusion. There were 49 patients analyzed from Group A, 28 from Group B, and 28 from Group C. Results Crude analysis of the data showed numerical differences in the total number of days and hours in isolation between the 3 groups. The average (mean) days in isolation were 4.2 for Group A, 7.4 for Group B, and 5.5 for Group C. There was no statistically significant difference in either days or hours of airborne precautions by “rule out” method. Days of isolation in airborne precautions (median IQR) was 4 for all groups (P = 0.3313). Likewise, hours of airborne precautions had a median IQR of 96 for all groups P = 0.4347. Conclusion Although there was no statistical significance between the groups, crude analysis did show a numerical difference in the mean total airborne days and hours. Lack of statistical difference may be due to low number of patients, timing of order placement for in-house PCR, and longer than expected stay in airborne precautions. Disclosures All authors: No reported disclosures.
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Perez, Bianca, Averi Segrest, Sofia Campos, Russell Minton, and Romi Burks. "First record of Japanese Mystery Snail Cipangopaludina japonica (von Martens, 1861) in Texas." Check List 12, no. (5) (2016): 1–17. https://doi.org/10.15560/12.5.1973.
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Two <em>Cipangopaludina</em> snails were discovered in Harris County, Texas, USA, during routine fieldwork in October 2015. Dissection yielded one male and one female containing 52 offspring in her brood pouch. Phylogenetic analysis of the cytochrome <em>c</em> oxidase subunit I (COI) gene confirmed both individuals to be <em>Cipangopaludina japonica</em> (von Martens, 1861). This is the first distribution record of <em>C. japonica </em>in Texas. Non-native invasive snails, such as <em>C. japonica, </em>compete with native species and may serve as reservoirs for parasites, prompting the need for increased diligence in monitoring public waterways.
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Pivovarov, Evgeny. "Records Concerned With The Russian Geographical Society In The Archive Of The Third Section Of His Imperial Majesty’s Own Chancellery." Voprosy istorii estestvoznaniia i tekhniki 44, no. 2 (2023): 341. http://dx.doi.org/10.31857/s020596060026199-0.
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The making of the Russian Geographical Society (RGO) occurred during the “grim seven years” of Nicholas I’s reign. The reaction to the “Springtime of the Peoples” affected all spheres of public life in the empire. Censorship was tightened and administrative and police oversight of education and science strengthened. This is the first publication of the complete texts of 9 previously unknown records (1848–1851) from the file “On the Russian Geographical Society”, stored in the holding (“fond”) No. 109 of the Third Section of His Imperial Majesty’s own Chancellery in the State Archive of the Russian Federation. The correspondence between the Head of the Section, A. F. Orlov, and his deputy, L. V. Dubelt, bespeaks their close attention to the RGO’s life: struggle between the factions in the RGO, elections of its governing bodies, and political sentiments among the RGO membership. These documents enable tracing the history of interaction between the RGO, state authorities, and other scientific organizations. Record 1 is Dubelt’s note “On the Geographical Society” of May 1, 1848, addressed to Orlov; record 2 is a memorandum “On the election of vice president of the Russian Geographical Society” of March 15, 1850, by an unknown author; and record 3 is a copy of a perlustrated letter from Count S. G. Stroganov to his brother, A. G. Stroganov, in which he discussed the results of the RGO vice-chairman election. Records 4 and 5 comprise the correspondence between Dubelt and Orlov that indicates that Stroganov’s letter became known to the Emperor. Outraged by Stroganov’s accusations, Dubelt prepared an explanatory note (record 6) for the Emperor. Dubelt’s harsher report to Nicholas I (records 7 and 9: draft report and its final version, respectively) was dated March of 1851. A short draft note with a list of persons involved in medal minting in St. Petersburg (record 8) was attached to the case. The publication is supplemented with an annotated list of names mentioned in these records.
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West, Jason, and Robert Harrison. "Texas-Mexico Cross Border Truck Operations: Are Mexican NAFTA Trucks Unsafe?" Journal of the Transportation Research Forum 47, no. 4 (2010). http://dx.doi.org/10.5399/osu/jtrf.47.4.1136.
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Texas Department of Public Safety (DPS) border safety inspection facilities (BSIF) have been in operation, in temporary and permanent forms, since 2001. This paper presents inspection results on trucks inspected at Texas BSIFs from 2003 to 2006, comprising over 326,000 vehicle inspection records. Analysis indicated that Mexico domiciled trucks have lower out-of-service rates than U.S. trucks at most Texas/Mexico border crossings. This finding is noteworthy since border (drayage) vehicles are older on average than typical Texas highway trucks and counters the opinion that trucks from Mexico are unsafe and therefore should not be allowed to enter the U.S.
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Ruch, Kayla E., Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, and Eric L. Brown. "Development, delivery, and evaluation of the Texas Epidemic Public Health Institute pilot infection control lecture series." Frontiers in Public Health 13 (March 12, 2025). https://doi.org/10.3389/fpubh.2025.1534560.
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IntroductionThe Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI’s Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.MethodsData from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to the public across disciplines. The material was promoted through public health channels with promotional flyers.Results1,105 individuals attended or viewed the Infection Control series. Despite a generally low response rate to evaluation surveys, feedback was consistently positive. Participants noted a “high likelihood of future TEPHI infection prevention and control lecture attendance.” The feedback informed improvements for the second year of the series.ConclusionAttendees of the Infection Control series gained a deeper understanding of relevant policies, procedures, and practices. By providing essential, accessible education on infection prevention and control at no cost, healthcare systems, administrators, and providers in rural healthcare systems across Texas have acquired the necessary knowledge to establish and maintain a safe environment for patients and staff in healthcare settings.
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Gray, Jay, and Jennifer Haney. "A Phase I Cultural Resource Survey for the Proposed Six Mile Boat Ramp Expansion Project (Texas Antiquities Permit #9155)." Index of Texas Archaeology Open Access Grey Literature from the Lone Star State, 2020. http://dx.doi.org/10.21112/ita.2020.1.47.
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Cultural Resource Analysts, Inc., personnel completed a records review and cultural resource survey for the proposed expansion of the existing Six Mile Boat Ramp in Sabine County, Texas. This work was performed to assist the Sabine River Authority of Texas in complying with Section 106 of the National Historic Preservation Act of 1966 (Public Law 89-665, 16 U.S.C. 470h-2) as an applicant for a Section 404 Clean Water Act Permit from the US Army Corps of Engineers, and the provisions of the Texas Administrative Code regarding archaeological resources on public lands. The Texas Administrative Code requires review of projects on state-owned lands by the Texas Antiquities Commission. The Sabine River Authority of Texas is considered a political subdivision of the State of Texas, and therefore it has a responsibility to provide the Texas Antiquities Commission an opportunity to review projects that may affect potential or designated archaeological sites. This project was performed under Texas Antiquities Permit (No. 9155). All work was performed pursuant to the guidelines published by the Council of Texas Archeologists and adopted by the Texas Historical Commission, and this report was prepared following the short report format in the Guidelines for Cultural Resource Management Reports published by the Council of Texas Archeologists. The current proposed project includes the expansion of the Six Mile Boat Ramp on the Toledo Bend Reservoir in Sabine County, Texas. The proposed development includes the addition of a handicap-accessible floating boat ramp, the clearing of approximately 0.4 ha (1.0 acre) of trees, the construction of a parking area, the addition of a vault toilet, the addition of two tables on concrete platforms, and the clearing of trees along the shoreline to provide an enhanced scenic view. In order to provide some flexibility in siting these facilities, the direct and visual areas of potential effect for this project were within a polygon adhering on its southern and western boundaries to the property line, and roughly buffered to the north and east by the existing shoreline of the Toledo Bend Reservoir. It is estimated that the area of potential effect for this project measures 1.2 ha (3.0 acres), of which approximately 0.9 ha (2.2 acres) could be surveyed, excluding paved surfaces. The records review for this project was conducted on October 18, 2019, prior to the commencement of the field survey, to identify cultural resources or cultural resource investigations previously documented within the area. This file search utilized online files maintained by the Texas Archaeological Research Laboratory at the University of Texas. Additionally, historic maps were examined to identify the locations of any potential historic archaeological sites. The records review indicated that one previously documented site, 41SB58, was located within approximately 50 m (164 ft) to the north of the proposed project area. Additionally, one historic structure was depicted within the project area on historic mapping. Fieldwork was conducted on November 19, 2019, and was completed in 11.5 person hours. The project area was systematically investigated by pedestrian survey and screened shovel tests spaced at a 30 m (98 ft) interval on pedestrian transects spaced at 30 m. The fieldwork for this project resulted in one newly recorded isolated find that is not eligible for designation as a Texas State Archeological Landmark or for listing in the National Register of Historic Places. Based on the findings of this work, it is recommended that the project area be considered cleared from a cultural resource perspective.