Oscar Wehmanen - Academia.edu (original) (raw)
Papers by Oscar Wehmanen
![Research paper thumbnail of Large Area Crop Inventory Experiment (LACIE). Detecting and monitoring agricultural vegetative water stress over large areas using LANDSAT digital data. [Great Plains]](https://attachments.academia-assets.com/100041275/thumbnails/1.jpg)
](The author has identified the following significant results. The Green Number Index technique whi... more The author has identified the following significant results. The Green Number Index technique which uses LANDSAT digital data from 5X6 nautical mile sampling frames was expanded to evaluate its usefulness in detecting and monitoring vegetative water stress over the Great Plains. At known growth stages for wheat, segments were classified as drought or non drought. Good agreement was found between the 18 day remotely sensed data and a weekly ground-based crop moisture index. Operational monitoring of the 1977 U.S.S.R. and Australian wheat crops indicated drought conditions. Drought isoline maps produced by the Green Number Index technique were in good agreement with conventional sources.
Journal of The American Statistical Association - J AMER STATIST ASSN, 1978
Eight nonparametric tests are examined in a small-sample setting. Their power functions are compa... more Eight nonparametric tests are examined in a small-sample setting. Their power functions are compared with the locally most powerful (LMP) linear rank test, primarily to see over which range the LMP test retains good power. All tests are two-sample tests, the populations are governed by the double exponential distribution, and the sample sizes are m = 5, n = 5, and m = 5, n = 4. The LMP test performs uniformly well, even under nonlocal alternatives, while its asymptotically equivalent counterpart, the median test, performs rather poorly with these small sample sizes.
Journal of the American Statistical Association, 1978
Eight nonparametric tests are examined in a small-sample setting. Their power functions are compa... more Eight nonparametric tests are examined in a small-sample setting. Their power functions are compared with the locally most powerful (LMP) linear rank test, primarily to see over which range the LMP test retains good power. All tests are two-sample tests, the populations are governed by the double exponential distribution, and the sample sizes are m = 5, n = 5, and m = 5, n = 4. The LMP test performs uniformly well, even under nonlocal alternatives, while its asymptotically equivalent counterpart, the median test, performs rather poorly with these small sample sizes.
Obstetrics and Gynecology, 2003
OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restricti... more OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restriction (FGR, birth weight less than 2500 g) and macrosomia (at least 4000 g) at or beyond 37 weeks.
Disease Management, 2004
Scant evidence exists that examines the impact of participation in primary care diabetes manageme... more Scant evidence exists that examines the impact of participation in primary care diabetes management programs and their educational components on the risk of subsequent significant patient morbidity. This study examined the association between participation in a diabetes management program in a primary care setting and the risk of subsequent hospitalization. Ten thousand nine hundred eighty patients with diabetes mellitus receiving some type of treatment in a large primary care clinic network in Houston, TX were examined for incidence of hospitalization in the year 2002. Information from the year preceding the hospitalization was obtained on several demographic, clinical, and diabetes care management participation related variables. Multivariate logistic regressions were used to examine the relationship between primary care diabetes management participation as well as individual educational components and the likelihood of subsequent-year hospitalization. Patients participating in some type of primary care diabetes management were 16% less likely to have an incidence of hospitalization (p = 0.05). When individual educational components of the diabetes care management program were examined, diabetes education sessions were more beneficial than certified diabetes educator visits in reducing the incidence of hospitalization. Patients with controlled blood glucose levels and a diabetes education session seemed to have the most significant reduction in hospitalization risk (odds ratio [OR] = 0.62; 95% CI: 0.40, 0.95). There seem to be beneficial effects associated with participation in primary care diabetes management programs in terms of reduced hospitalization risk. Attendance at diabetes educational sessions in primary care settings coupled with maintenance of blood glucose control seem to be associated with greatest risk reduction.
Disease Management, 2008
We evaluated the effect of a disease management (DM) program on adherence with recommended labora... more We evaluated the effect of a disease management (DM) program on adherence with recommended laboratory tests, health outcomes, and health care expenditures for patients with type 2 diabetes. The study was a natural experiment in a primary care setting in which the intervention was available to 1 group and then compared to the experience of a matched control group. Univariate analysis and difference in differences analysis were used to test for any significant differences between the 2 groups following a 12-month intervention period. A payer perspective was used to estimate the health care cost consequences based on hospital and physician utilization weighted by Medicare prices. The results were nonsignificant at the .10 level, except for compliance with recommended tests, which showed significant results in the univariate analysis. The intervention increased compliance with testing for HbA1c, microalbuminuria, and lipids, and decreased HbA1c value and the percent of patients with HbA1c >or=9.5%. The point estimates showed small reductions in health care cost; only reductions in costs for office visits were significant at the .10 level. We concluded that while there were signs of improvement in adherence to testing, the low effectiveness may be attributed to existing diabetes management activities in this primary care setting, high compliance rates for testing at the beginning of the study, and a steep learning curve for this complex, information-technology-based DM system. The study raises questions about the incremental gains from complex systems approaches to DM and illustrates a rigorous method to assess DM programs under "real-world" conditions, with control for possible selection bias.
Disease Management, 2004
Scant evidence exists that examines the impact of participation in primary care diabetes manageme... more Scant evidence exists that examines the impact of participation in primary care diabetes management programs and their educational components on the risk of subsequent significant patient morbidity. This study examined the association between participation in a diabetes management program in a primary care setting and the risk of subsequent hospitalization. Ten thousand nine hundred eighty patients with diabetes mellitus receiving some type of treatment in a large primary care clinic network in Houston, TX were examined for incidence of hospitalization in the year 2002. Information from the year preceding the hospitalization was obtained on several demographic, clinical, and diabetes care management participation related variables. Multivariate logistic regressions were used to examine the relationship between primary care diabetes management participation as well as individual educational components and the likelihood of subsequent-year hospitalization. Patients participating in some type of primary care diabetes management were 16% less likely to have an incidence of hospitalization (p = 0.05). When individual educational components of the diabetes care management program were examined, diabetes education sessions were more beneficial than certified diabetes educator visits in reducing the incidence of hospitalization. Patients with controlled blood glucose levels and a diabetes education session seemed to have the most significant reduction in hospitalization risk (odds ratio [OR] = 0.62; 95% CI: 0.40, 0.95). There seem to be beneficial effects associated with participation in primary care diabetes management programs in terms of reduced hospitalization risk. Attendance at diabetes educational sessions in primary care settings coupled with maintenance of blood glucose control seem to be associated with greatest risk reduction.
Journal of Clinical Psychology in Medical Settings, 2010
Physical illness may precipitate psychological distress among older adults. This study examines w... more Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.
American Journal of Obstetrics and Gynecology, 2005
The purpose of this study was to evaluate the safety of influenza vaccine that is administered in... more The purpose of this study was to evaluate the safety of influenza vaccine that is administered in the second or third trimester of gestation.A retrospective electronic database search of 5 influenza seasons (July 1, 1998, to June 30, 2003) was performed at a large multispecialty clinic in Houston, Texas. Immunization rates were calculated, and outcomes of pregnancy were compared between a cohort of healthy women who received influenza vaccine and a control group of healthy unvaccinated women who were matched by age, month of delivery, and type of medical insurance.Among 7183 eligible mother-infant pairs, only 252 pregnant women (3.5%) received the influenza vaccine. Women with medical insurance were more likely to be vaccinated, although the rates for women with chronic underlying conditions were similar to those of healthy women, regardless of insurance status. The mean gestational age at the time of influenza vaccination was 26.1 weeks (range, 14-39 weeks). No serious adverse events occurred within 42 days of vaccination, and there was no difference between the groups in the outcomes of pregnancy (including cesarean delivery and premature delivery) and infant medical conditions from birth to 6 months of age.Influenza vaccine that was administered in the second or third trimester of gestation was safe in this study population.
Obstetrics & Gynecology, 2003
OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restricti... more OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restriction (FGR, birth weight less than 2500 g) and macrosomia (at least 4000 g) at or beyond 37 weeks.
Journal of Clinical Psychology in Medical Settings, 2010
Physical illness may precipitate psychological distress among older adults. This study examines w... more Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when selfefficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.
Journal of Clinical Psychology in Medical Settings, 2009
Background-Primary care physicians often treat older adults with Generalized Anxiety Disorder.
Journal of Clinical Lipidology, 2007
Journal of Clinical Lipidology, 2010
OBJECTIVE: The objective of this study was to determine whether enrollment in a multidisciplinary... more OBJECTIVE: The objective of this study was to determine whether enrollment in a multidisciplinary secondary prevention lipid clinic (SPLC) for 3 or more years was associated with improved adherence to lipid guidelines as compared with usual care provided by cardiologists.
Infectious Diseases in Obstetrics and Gynecology, 2010
Objective. To assess the effect of universal screening and administration of intrapartum antibiot... more Objective. To assess the effect of universal screening and administration of intrapartum antibiotic prophylaxis to prevent earlyonset neonatal GBS sepsis at a private tertiary care hospital since issuance of the 2002 CDC guidelines for preventing perinatal GBS disease. Methods. Retrospective analysis of women delivering between January 1, 2003 and December 31, 2004 at a private tertiary care hospital in Houston, Texas. The percentage of women screened, GBS positive women receiving intrapartum antibiotic prophylaxis, and infants developing early-onset GBS sepsis were determined. Results. 2,108 women delivered 2,135 infants with 1,874 (89%) screened for GBS. Of those screened, 1,322 (71%) tested negative and 552 (29%) tested positive for GBS. In this analysis of 2,135 infants, 3 (0.94 cases/1,000 live births) were diagnosed with invasive GBS sepsis. Conclusion. High rates of screening of pregnant women for GBS colonization and use of intrapartum antibiotic prophylaxis for GBS carriers can be achieved in a private tertiary care hospital setting. "Synopsis: High screening rates for group B streptococcus in a private tertiary care hospital reduce the incidence of maternal and early onset neonatal GBS infection." of Hindawi Publishing Corporation
Infectious Diseases in Obstetrics and Gynecology, 2013
Background. Infants born to mothers who are colonized with group B streptococcus (GBS) but receiv... more Background. Infants born to mothers who are colonized with group B streptococcus (GBS) but received <4 hours of intrapartum antibiotic prophylaxis (IAP) are at-risk for presenting later with sepsis. We assessed if <4 hours of maternal IAP for GBS are associated with an increased incidence of clinical neonatal sepsis. Materials and Methods. A retrospective cohort study of womeninfant dyads undergoing IAP for GBS at ≥37-week gestation who presented in labor from January 1, 2003 through December 31, 2007 was performed. Infants diagnosed with clinical sepsis by the duration of maternal IAP received (< or ≥4-hours duration) were determined. Results. More infants whose mothers received <4 hours of IAP were diagnosed with clinical sepsis, 13 of 1,149 (1.1%) versus 15 of 3,633 (0.4%), = .03. Multivariate logistic regression analysis showed that treatment with ≥4 hours of IAP reduced the risk of infants being diagnosed with clinical sepsis by 65%, adjusted relative risk 0.35, CI 0.16-0.79, and = .01. Conclusion. The rate of neonatal clinical sepsis is increased in newborns of GBS colonized mothers who receive <4 hours compared to ≥4 hours of IAP.
Journal of Clinical Lipidology, 2010
The objective of this study was to determine whether enrollment in a multidisciplinary secondary ... more The objective of this study was to determine whether enrollment in a multidisciplinary secondary prevention lipid clinic (SPLC) for 3 or more years was associated with improved adherence to lipid guidelines as compared with usual care provided by cardiologists.Patients with documented coronary artery disease (CAD), enrolled in a SPLC, and followed for at least 3 years were identified by the use of a computer database. The comparison group included patients with CAD who received usual care from a cardiologist during the same time period. The percentage of patients achieving low-density lipoprotein cholesterol (LDL-C) goals at enrollment and after at least 3 years of follow-up was determined for both groups. The average total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined after at least 3 years of follow-up for both groups.Patients enrolled in the SPLC reached the LDL-C goals more often than usual care cardiology patients (goal <100 mg/dL: 81.9% vs. 72.8%, P < .001; optional goal < 70 mg/dL: 41.9% vs. 28.6%, P < .001). The patients enrolled in the SPLC had lower average total cholesterol, triglycerides, and LDL-C and greater average HDL-C after 3 years. All the lipid parameters decreased for patients in usual cardiology care, but these changes were not statistically significant.This multidisciplinary secondary prevention lipid clinic achieved the LDL-C goals (<100 mg/dL and optional goal <70 mg/dL) more often than usual cardiology care for patients with CAD after 3 years of lipid management.
American Journal of Obstetrics and Gynecology, 2013
American Journal of Obstetrics and Gynecology, 2005
The author has identified the following significant results. The Green Number Index technique whi... more The author has identified the following significant results. The Green Number Index technique which uses LANDSAT digital data from 5X6 nautical mile sampling frames was expanded to evaluate its usefulness in detecting and monitoring vegetative water stress over the Great Plains. At known growth stages for wheat, segments were classified as drought or non drought. Good agreement was found between the 18 day remotely sensed data and a weekly ground-based crop moisture index. Operational monitoring of the 1977 U.S.S.R. and Australian wheat crops indicated drought conditions. Drought isoline maps produced by the Green Number Index technique were in good agreement with conventional sources.
Journal of The American Statistical Association - J AMER STATIST ASSN, 1978
Eight nonparametric tests are examined in a small-sample setting. Their power functions are compa... more Eight nonparametric tests are examined in a small-sample setting. Their power functions are compared with the locally most powerful (LMP) linear rank test, primarily to see over which range the LMP test retains good power. All tests are two-sample tests, the populations are governed by the double exponential distribution, and the sample sizes are m = 5, n = 5, and m = 5, n = 4. The LMP test performs uniformly well, even under nonlocal alternatives, while its asymptotically equivalent counterpart, the median test, performs rather poorly with these small sample sizes.
Journal of the American Statistical Association, 1978
Eight nonparametric tests are examined in a small-sample setting. Their power functions are compa... more Eight nonparametric tests are examined in a small-sample setting. Their power functions are compared with the locally most powerful (LMP) linear rank test, primarily to see over which range the LMP test retains good power. All tests are two-sample tests, the populations are governed by the double exponential distribution, and the sample sizes are m = 5, n = 5, and m = 5, n = 4. The LMP test performs uniformly well, even under nonlocal alternatives, while its asymptotically equivalent counterpart, the median test, performs rather poorly with these small sample sizes.
Obstetrics and Gynecology, 2003
OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restricti... more OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restriction (FGR, birth weight less than 2500 g) and macrosomia (at least 4000 g) at or beyond 37 weeks.
Disease Management, 2004
Scant evidence exists that examines the impact of participation in primary care diabetes manageme... more Scant evidence exists that examines the impact of participation in primary care diabetes management programs and their educational components on the risk of subsequent significant patient morbidity. This study examined the association between participation in a diabetes management program in a primary care setting and the risk of subsequent hospitalization. Ten thousand nine hundred eighty patients with diabetes mellitus receiving some type of treatment in a large primary care clinic network in Houston, TX were examined for incidence of hospitalization in the year 2002. Information from the year preceding the hospitalization was obtained on several demographic, clinical, and diabetes care management participation related variables. Multivariate logistic regressions were used to examine the relationship between primary care diabetes management participation as well as individual educational components and the likelihood of subsequent-year hospitalization. Patients participating in some type of primary care diabetes management were 16% less likely to have an incidence of hospitalization (p = 0.05). When individual educational components of the diabetes care management program were examined, diabetes education sessions were more beneficial than certified diabetes educator visits in reducing the incidence of hospitalization. Patients with controlled blood glucose levels and a diabetes education session seemed to have the most significant reduction in hospitalization risk (odds ratio [OR] = 0.62; 95% CI: 0.40, 0.95). There seem to be beneficial effects associated with participation in primary care diabetes management programs in terms of reduced hospitalization risk. Attendance at diabetes educational sessions in primary care settings coupled with maintenance of blood glucose control seem to be associated with greatest risk reduction.
Disease Management, 2008
We evaluated the effect of a disease management (DM) program on adherence with recommended labora... more We evaluated the effect of a disease management (DM) program on adherence with recommended laboratory tests, health outcomes, and health care expenditures for patients with type 2 diabetes. The study was a natural experiment in a primary care setting in which the intervention was available to 1 group and then compared to the experience of a matched control group. Univariate analysis and difference in differences analysis were used to test for any significant differences between the 2 groups following a 12-month intervention period. A payer perspective was used to estimate the health care cost consequences based on hospital and physician utilization weighted by Medicare prices. The results were nonsignificant at the .10 level, except for compliance with recommended tests, which showed significant results in the univariate analysis. The intervention increased compliance with testing for HbA1c, microalbuminuria, and lipids, and decreased HbA1c value and the percent of patients with HbA1c &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=9.5%. The point estimates showed small reductions in health care cost; only reductions in costs for office visits were significant at the .10 level. We concluded that while there were signs of improvement in adherence to testing, the low effectiveness may be attributed to existing diabetes management activities in this primary care setting, high compliance rates for testing at the beginning of the study, and a steep learning curve for this complex, information-technology-based DM system. The study raises questions about the incremental gains from complex systems approaches to DM and illustrates a rigorous method to assess DM programs under &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;real-world&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; conditions, with control for possible selection bias.
Disease Management, 2004
Scant evidence exists that examines the impact of participation in primary care diabetes manageme... more Scant evidence exists that examines the impact of participation in primary care diabetes management programs and their educational components on the risk of subsequent significant patient morbidity. This study examined the association between participation in a diabetes management program in a primary care setting and the risk of subsequent hospitalization. Ten thousand nine hundred eighty patients with diabetes mellitus receiving some type of treatment in a large primary care clinic network in Houston, TX were examined for incidence of hospitalization in the year 2002. Information from the year preceding the hospitalization was obtained on several demographic, clinical, and diabetes care management participation related variables. Multivariate logistic regressions were used to examine the relationship between primary care diabetes management participation as well as individual educational components and the likelihood of subsequent-year hospitalization. Patients participating in some type of primary care diabetes management were 16% less likely to have an incidence of hospitalization (p = 0.05). When individual educational components of the diabetes care management program were examined, diabetes education sessions were more beneficial than certified diabetes educator visits in reducing the incidence of hospitalization. Patients with controlled blood glucose levels and a diabetes education session seemed to have the most significant reduction in hospitalization risk (odds ratio [OR] = 0.62; 95% CI: 0.40, 0.95). There seem to be beneficial effects associated with participation in primary care diabetes management programs in terms of reduced hospitalization risk. Attendance at diabetes educational sessions in primary care settings coupled with maintenance of blood glucose control seem to be associated with greatest risk reduction.
Journal of Clinical Psychology in Medical Settings, 2010
Physical illness may precipitate psychological distress among older adults. This study examines w... more Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.
American Journal of Obstetrics and Gynecology, 2005
The purpose of this study was to evaluate the safety of influenza vaccine that is administered in... more The purpose of this study was to evaluate the safety of influenza vaccine that is administered in the second or third trimester of gestation.A retrospective electronic database search of 5 influenza seasons (July 1, 1998, to June 30, 2003) was performed at a large multispecialty clinic in Houston, Texas. Immunization rates were calculated, and outcomes of pregnancy were compared between a cohort of healthy women who received influenza vaccine and a control group of healthy unvaccinated women who were matched by age, month of delivery, and type of medical insurance.Among 7183 eligible mother-infant pairs, only 252 pregnant women (3.5%) received the influenza vaccine. Women with medical insurance were more likely to be vaccinated, although the rates for women with chronic underlying conditions were similar to those of healthy women, regardless of insurance status. The mean gestational age at the time of influenza vaccination was 26.1 weeks (range, 14-39 weeks). No serious adverse events occurred within 42 days of vaccination, and there was no difference between the groups in the outcomes of pregnancy (including cesarean delivery and premature delivery) and infant medical conditions from birth to 6 months of age.Influenza vaccine that was administered in the second or third trimester of gestation was safe in this study population.
Obstetrics & Gynecology, 2003
OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restricti... more OBJECTIVE: To determine if abdominal circumference (AC) alone can identify fetal growth restriction (FGR, birth weight less than 2500 g) and macrosomia (at least 4000 g) at or beyond 37 weeks.
Journal of Clinical Psychology in Medical Settings, 2010
Physical illness may precipitate psychological distress among older adults. This study examines w... more Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when selfefficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.
Journal of Clinical Psychology in Medical Settings, 2009
Background-Primary care physicians often treat older adults with Generalized Anxiety Disorder.
Journal of Clinical Lipidology, 2007
Journal of Clinical Lipidology, 2010
OBJECTIVE: The objective of this study was to determine whether enrollment in a multidisciplinary... more OBJECTIVE: The objective of this study was to determine whether enrollment in a multidisciplinary secondary prevention lipid clinic (SPLC) for 3 or more years was associated with improved adherence to lipid guidelines as compared with usual care provided by cardiologists.
Infectious Diseases in Obstetrics and Gynecology, 2010
Objective. To assess the effect of universal screening and administration of intrapartum antibiot... more Objective. To assess the effect of universal screening and administration of intrapartum antibiotic prophylaxis to prevent earlyonset neonatal GBS sepsis at a private tertiary care hospital since issuance of the 2002 CDC guidelines for preventing perinatal GBS disease. Methods. Retrospective analysis of women delivering between January 1, 2003 and December 31, 2004 at a private tertiary care hospital in Houston, Texas. The percentage of women screened, GBS positive women receiving intrapartum antibiotic prophylaxis, and infants developing early-onset GBS sepsis were determined. Results. 2,108 women delivered 2,135 infants with 1,874 (89%) screened for GBS. Of those screened, 1,322 (71%) tested negative and 552 (29%) tested positive for GBS. In this analysis of 2,135 infants, 3 (0.94 cases/1,000 live births) were diagnosed with invasive GBS sepsis. Conclusion. High rates of screening of pregnant women for GBS colonization and use of intrapartum antibiotic prophylaxis for GBS carriers can be achieved in a private tertiary care hospital setting. "Synopsis: High screening rates for group B streptococcus in a private tertiary care hospital reduce the incidence of maternal and early onset neonatal GBS infection." of Hindawi Publishing Corporation
Infectious Diseases in Obstetrics and Gynecology, 2013
Background. Infants born to mothers who are colonized with group B streptococcus (GBS) but receiv... more Background. Infants born to mothers who are colonized with group B streptococcus (GBS) but received <4 hours of intrapartum antibiotic prophylaxis (IAP) are at-risk for presenting later with sepsis. We assessed if <4 hours of maternal IAP for GBS are associated with an increased incidence of clinical neonatal sepsis. Materials and Methods. A retrospective cohort study of womeninfant dyads undergoing IAP for GBS at ≥37-week gestation who presented in labor from January 1, 2003 through December 31, 2007 was performed. Infants diagnosed with clinical sepsis by the duration of maternal IAP received (< or ≥4-hours duration) were determined. Results. More infants whose mothers received <4 hours of IAP were diagnosed with clinical sepsis, 13 of 1,149 (1.1%) versus 15 of 3,633 (0.4%), = .03. Multivariate logistic regression analysis showed that treatment with ≥4 hours of IAP reduced the risk of infants being diagnosed with clinical sepsis by 65%, adjusted relative risk 0.35, CI 0.16-0.79, and = .01. Conclusion. The rate of neonatal clinical sepsis is increased in newborns of GBS colonized mothers who receive <4 hours compared to ≥4 hours of IAP.
Journal of Clinical Lipidology, 2010
The objective of this study was to determine whether enrollment in a multidisciplinary secondary ... more The objective of this study was to determine whether enrollment in a multidisciplinary secondary prevention lipid clinic (SPLC) for 3 or more years was associated with improved adherence to lipid guidelines as compared with usual care provided by cardiologists.Patients with documented coronary artery disease (CAD), enrolled in a SPLC, and followed for at least 3 years were identified by the use of a computer database. The comparison group included patients with CAD who received usual care from a cardiologist during the same time period. The percentage of patients achieving low-density lipoprotein cholesterol (LDL-C) goals at enrollment and after at least 3 years of follow-up was determined for both groups. The average total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined after at least 3 years of follow-up for both groups.Patients enrolled in the SPLC reached the LDL-C goals more often than usual care cardiology patients (goal <100 mg/dL: 81.9% vs. 72.8%, P < .001; optional goal < 70 mg/dL: 41.9% vs. 28.6%, P < .001). The patients enrolled in the SPLC had lower average total cholesterol, triglycerides, and LDL-C and greater average HDL-C after 3 years. All the lipid parameters decreased for patients in usual cardiology care, but these changes were not statistically significant.This multidisciplinary secondary prevention lipid clinic achieved the LDL-C goals (<100 mg/dL and optional goal <70 mg/dL) more often than usual cardiology care for patients with CAD after 3 years of lipid management.
American Journal of Obstetrics and Gynecology, 2013
American Journal of Obstetrics and Gynecology, 2005