BACKGROUND: In Korea, the Korean Laboratory Accreditation Program (KLAP) has set minimum standards for verification of clinical test performance. This verification process is time-consuming and labor-intensive when performed manually. We developed a free, statistical software program for KLAP, using the R language (R Foundation for Statistical Computing, Vienna, Austria). METHODS: We used CLSI guidelines for the algorithm. We built graphic user interfaces, including data input, with Embarcadero Delphi EX4 (Embarcadero Technologies, Inc., Texas, USA). The R Base Package and MCR Package for Method Comparison Regression were used to implement statistical and graphical procedures. RESULTS: Our program LaboStats has six modules: parallel test, linearity, method comparison, precision, reference interval, and cutoff. Data can be entered into the field either manually or by copying and pasting from an MS Excel worksheet. Users can print out precise reports. CONCLUSIONS: LaboStats can be useful for evaluating clinical test performance characteristics and preparing documents requested by KLAP.
Accreditation ; Korea ; Mathematical Computing ; Methods ; Texas

There is limited literature on the frequency and distribution of pesticide exposures, specifically with respect to demographic and environmental factors in the United States. The purpose of this exploratory study was to investigate geographic trends and factors associated with unintentional pesticide exposures in children and adolescents in Texas. The study used an ecological design with secondary data. A spatial scan statistic, based on a Poisson regression model, was employed to identify spatial clusters of unintentional pesticide-related poison center exposures. Next, logistic regression models were constructed to identify potential demographic and environmental factors associated with unintentional pesticide-related poison center exposures. There were 59,477 unintentional pesticide-related poison center exposures from 2000 to 2013. The spatial scan statistic found a change in the number of counties in the identified clusters (e.g. , aggregation of counties with higher than expected exposures) for two time periods (2000-2006; 2007-2013). Based on the logistic regression models, factors associated with unintentional pesticide-related poison center exposures were percent black or African American population, year structure built, and percent moved in the past 12 months. In conclusion, this study found certain demographic and environmental factors may be associated with unintentional pesticide-related poison center exposures. Through understanding trends and associated factors, public health professionals can design interventions for populations at higher risk of pesticide exposures. This study also supports the use of spatial methods being utilized to expand upon current analysis of poison center data. Future research should confirm and build upon these findings.
Adolescent ; Child ; Humans ; Logistic Models ; Pesticides ; Poisoning ; Public Health ; Texas ; United States

There is limited literature on the frequency and distribution of pesticide exposures, specifically with respect to demographic and environmental factors in the United States. The purpose of this exploratory study was to investigate geographic trends and factors associated with unintentional pesticide exposures in children and adolescents in Texas. The study used an ecological design with secondary data. A spatial scan statistic, based on a Poisson regression model, was employed to identify spatial clusters of unintentional pesticide-related poison center exposures. Next, logistic regression models were constructed to identify potential demographic and environmental factors associated with unintentional pesticide-related poison center exposures. There were 59,477 unintentional pesticide-related poison center exposures from 2000 to 2013. The spatial scan statistic found a change in the number of counties in the identified clusters (e.g. , aggregation of counties with higher than expected exposures) for two time periods (2000-2006; 2007-2013). Based on the logistic regression models, factors associated with unintentional pesticide-related poison center exposures were percent black or African American population, year structure built, and percent moved in the past 12 months. In conclusion, this study found certain demographic and environmental factors may be associated with unintentional pesticide-related poison center exposures. Through understanding trends and associated factors, public health professionals can design interventions for populations at higher risk of pesticide exposures. This study also supports the use of spatial methods being utilized to expand upon current analysis of poison center data. Future research should confirm and build upon these findings.
Adolescent* ; Child* ; Humans ; Logistic Models ; Pesticides ; Poisoning* ; Public Health ; Texas* ; United States

OBJECTIVES: To determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias. METHODS: The dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale. RESULTS: Enlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p < 0.001) unit increase in sedentary break and a −0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (β=0.296; p=0.002) and PASS scores (β=0.076; p < 0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration. CONCLUSIONS: The findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.
Community-Based Participatory Research ; Female ; Health Equity ; Humans ; Linear Models ; Medically Uninsured ; Mexico ; Motor Activity* ; Residence Characteristics* ; Texas*

No abstract available.
Texas

No abstract available.
Texas

PURPOSE: To describe the emergence of the North Texas Korean American Nurses Society (NTKANS) and to examine its sociocultural contributions to Korean immigrant societies in the U.S. for the last half century. METHODS: The study used retrospective historical analysis to explore the first North Texas Korean immigrant nurses' footsteps. Using Christy's historical research methodology, this study explored themes found in the NTKANS Minutes, the directories, and newspapers, and compared them with historical nursing contexts found in documents, immigrant nurse's pictures, and letters. Interviews with twenty first immigrant Korean nurses, the members, were also used as main data. RESULTS: Since its emergence in 1969, the NTKANS have contributed to local Korean societies through community medical services, financial supports to local Korean associations, local publications, and opening Korean school. In addition, the society has contributed to the other Korean immigrant nursing societies in the U.S. CONCLUSION: The sociocultural contributions NTKANS had made to Korean immigrant societies were not possible without its members' enormous efforts, personal struggles, and altruistic dedications. The trials and tribulations these immigrant nurses have overcome and the achievements they made for last half century would greatly inspire students and nurses in Korea who may seek international leadership and scholarship.
Achievement ; Anniversaries and Special Events ; Asian Americans ; Emigrants and Immigrants ; Fellowships and Scholarships ; Financial Support ; Humans ; Korea ; Leadership ; Periodicals ; Research Design ; Retrospective Studies ; Societies, Nursing ; Texas

OBJECTIVES: This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). METHODS: Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, average dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, voluntarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. RESULTS: Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). CONCLUSION: We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.
Adolescent ; Anxiety Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Consensus ; Depressive Disorder ; Humans ; Psychiatry ; Texas ; Tic Disorders ; Surveys and Questionnaires

BACKGROUND: The differential diagnosis of bullous pemphigoid (BP) and epidermolysis bullosa acquisita (EBA) presents some difficulties since both diseases have overlapping clinical and histological features, as well as immunopathological findings. Confocal laser scanning microscopy (CLSM) has been developed and has shown to be a promising tool for dermatological investigations, giving a higher degree of resolution and available co-localization analysis. OBJECTIVE: The purpose of this study was to evaluate whether the new technique of CLSM could reliably identify and differentiate the binding sites of disease specific-autoantibodies (Abs) at the basement membrane zone (BMZ), with the sera from BP and EBA. METHODS: An indirect immunofluorescence (IF) assay was performed to localize the binding sites of circulating Abs from 5 cases of both BP and EBA, as well as the sites of 3 BMZ markers (integrin beta4, laminin-5, and type IV collagen). To facilitate identification and topographic differentiation between the two groups, patients' Abs were labeled with fluorescein isothiocyanate, whereas the BMZ markers were labeled with Texas red. The tissue specimens were observed under both conventional IF microscopy and CLSM. RESULTS: Owing to superposition of antigens and marker labels, double immuno-labeled sections under IF microscopy revealed limitations for the differentiation of patient's sera from BMZ markers even with high magnification (x1,000). However, CLSM was able to eliminate much of the antigen overlap. In BP, the circulating autoantibody' deposits were recognized on the epidermal side of laminin-5 and type IV collagen, and codistributed with integrin beta4. On the other hand, the binding of autoantibodies in EBA was on the dermal side from that of integrin beta4, laminin-5 and type IV collagen. These spatial relationships are compatible with their known microstructural locations. CONCLUSION: Our study indicates that CLSM examination may provide more precise localization of the antigens in BP and EBA than conventional IF microscopy. CLSM would not only be an efficient tool to identify circulating anti-BMZ autoantibodies for diagnosis and differential diagnosis of blistering diseases, but also a great addition to examining tissue specimens in patients who do not have detectable circulating Abs.
Autoantibodies ; Basement Membrane ; Binding Sites ; Blister ; Collagen Type IV ; Diagnosis ; Diagnosis, Differential* ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescein ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Indirect ; Hand ; Humans ; Integrin beta4 ; Microscopy ; Microscopy, Confocal* ; Pemphigoid, Bullous* ; Texas

After publishing 2001 version of the Korean Medication Algorithm for Schizophrenia, the strategy of pharmacologic treatment for schizophrenia has been altered with the rapid advancement in the area of psychopharmacology. Currently, the feasibility of this algorithm has been evaluated. Guidelines require updating when significant new evidence appears. Recently, several guidelines of the treatment of schizophrenia including the APA practice guideline, the Expert Consensus Guideline Series and the Texas Medication Algorithm Project (TMAP) Antipsychotic Algorithm for Schizophrenia were revised. In this review, the authors briefly discussed the problems and limitations of the Korean Medication Algorithm for Schizophrenia and presented the direction of future revision on the model of above-mentioned guidelines.
Consensus ; Drug Therapy ; Methods* ; Practice Guidelines as Topic ; Psychopharmacology ; Schizophrenia* ; Texas